Officials from a health care advocacy group have presented something of a road map to the state leaders at the Maryland Health Exchange Board, whose members are working to implement the national health care reform law.

The Maryland Citizens’ Health Initiative officials say the plan would make health care more affordable.

They also pledged to help get the state officials new legal authority to implement some of the suggestions – the state legislature will be defining the board’s duties more clearly during the next session.

The proposal was supported by documents prepared by the Johns Hopkins Bloomberg School of Public Health, the Center for Medical Technology Policy, and America’s Agenda.

“We are proposing policies to the exchange board which will help to make quality health care affordable for all Marylanders,’ said Vincent DeMarco, president of the Maryland Citizens’ Health Initiative.

“We want the Board to have maximum flexibility to use proven methods such as active purchasing and selective contracting as well as encouraging primary care medical homes that make health care more affordable,” he said. “We will mobilize the over 1200 faith, community, labor, business and health care groups in our statewide coalition to support legislation to give the board this authority.”

DeMarco also pushed the idea of upping the state tobacco tax to help fund some initiatives.

The extensive proposal can be viewed here.

Posted by Meredith Cohn at 6:54 PM | Permalink | Comments (0)
Categories: Health care reform
        

**UPDATE: Gov. Martin O'Malley responds to the Supreme Court's decision to review the Affordable Care Act. 

As expected, the Supreme Court has agreed this morning to hear a case on the national health care reform law.

The main issue has been the mandate that all Americans buy health insurance or face a fine. Supporters say this is a critical piece of the law because is spreads risk around and controls premiums. Opponents say this is unconstitutional and the Eleventh Circuit Court of Appeals was the only appeals court to agree.

The Supreme Court also plans to hear a challenge to the expansion of Medicaid, the health program for the poor. Some states objected, though the federal government would pick up the bulk of the costs.

Ron Pollack, the executive director of the consumer health organization Families USA, said reversing the expansion would jeopardize health care to millions at a time when it’s needed most. But he did welcome review of the lower court’s decision on the constitutionality of the mandate to buy insurance.

“The individual responsibility provision is designed to make sure that people who can afford to purchase insurance do so, rather than passing their health care costs onto everyone else,” he said.

On the other side, Michael A. Needham, chief executive of the Heritage Action for America,  “We are hopeful America’s system of checks and balances will right this unprecedented wrong and overturn Obamacare in its entirety. At the same time, however, Heritage Action will continue to push Congress to repeal Obamacare in its entirety because the stakes are too high to put all our eggs in one basket.”

This Tribune story says a decision could come in June.

*Here's O'Malley's statement:

“In Maryland, over the past five years, we have expanded health care coverage to 290,000 previously uninsured Marylanders, 135,000 of them children. And thanks to President Obama’s leadership, the Affordable Care Act would save our State nearly $830 million over the next 10 years and provide coverage to nearly 400,000 Marylanders.

“We welcome the Supreme Court’s decision to consider the challenges to the Affordable Care Act. The Court should uphold the law, and achieving certainty will be of benefit to states’ implementation efforts. In the meantime, it is the law of the land, and we will continue our work to ensure that our State is on track to have an operational health benefit exchange by 2014 and prepared to bring the full benefits of health care reform to all Marylanders.”

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Categories: Health care reform
        

Maryland will receive a $1.9 million grant to prevent chronic diseases under a program created by the federal health care reform law. The grants, $103 million given out in 36 states, are aimed at reducing the biggest killers in the country, diabetes, heart disease and stokes.

In Maryland, the Community Transformation Grant will be administered by the state Department of Health and Mental Hygiene in 19 smaller jurisdictions.

Lt. Governor Anthony Brown said, “This grant will allow us to expand our efforts to prevent obesity, tobacco use, high blood pressure, and high cholesterol – the leading causes of chronic diseases – and help build stronger, healthier communities.”

The money will go toward Healthiest Maryland, a campaign that engages leadership, school, businesses and health care in communities to adopt wellness practices.

State health officials say the outcome should not only improve health but save money – 70 percent of all deaths and 75 percent of medical costs are attributed to chronic conditions, many of them preventable.

The five-year grants will be overseen by the U.S. Centers for Disease Control and Prevention, which says priority areas will be reduced tobacco use, exercise and improved diet and preventive services. They also will focus on reducing health disparities.

For more information on state programs and prevention efforts, click here or here.  

Posted by Meredith Cohn at 6:05 PM | Permalink | Comments (0)
Categories: Health care reform
        

Johns Hopkins Bayview Medical Center has won a grant that officials plan to use to determine ways of reducing use of an expensive diagnostic test.

The grant is from the ABIM Foundation, which has partnered with the Council of Medical Specialty Societies, and aims to foster development of innovative decision making strategies when it comes to health care resources. Goals are improving quality and access to care, fairly distributing resources and managing conflicts of interest.

Hopkins will focus on reducing use of the common cardiac enzyme panel by lining up doctor orders with established guidelines for testing.

“This project aims to reduce a significant inefficiency in the practice of medicine - overutilization of diagnostic laboratory testing - with regard to the evaluation of patients with acute coronary syndrome,” Dr. Jeff Trost, assistant professor of cardiology and deputy director for clinical practice in the Bayview’s department of medicine, said in a statement.

“For a variety of reasons, providers sometimes order more lab tests than are needed to make or exclude the diagnosis of acute coronary syndrome.”

Bayview officials plan to educate providers on the guidelines and create an electronic barrier to prevent overuse. They expect to save patients money, time and “needle sticks.”

Other grant that are coming under the Putting the Charter into Practice banner include the American College of Physicians, National Physicians Alliance, the Boston based non-profit Costs of Care and the University of Minnesota's Division of Pediatric Emergency Medicine.

For more information about the ABIM Foundation and the grantees, go to www.abimfoundation.org.

Posted by Meredith Cohn at 12:30 PM | Permalink | Comments (0)
Categories: Health care reform
        

Hoping to capitalize on news on the Census that 500,000 young adults gained health care coverage last year because of a provision in the federal health care reform law, a group called Young Invincibles is pushing more college students to know their new rights.

The health care law allows the these young adults to stay on their parents’ health insurance until they are 26.

The campaign is called “Friends with Benefits” and run though this week. The group created a toolkit with state specific information on student health care options. They hope to reach 200,000 young adults, who will share the information with their friends.

“We think Friends With Benefits Week is a great chance to engage young people on the importance of health care and explain their options,” said Aaron Smith, executive director and co-founder of the advocacy group, Young Invincibles, in a statement. “Finding the right insurance can be a confusing process, which is why we created the Back-To-School Toolkit. It’s our hope that young people will use the Toolkit as a resource on campus, so everyone has the coverage and care they need to stay healthy this school year.”

Are you getting health care on your parents' plan, or again providing it to your children?

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Categories: Health care reform
        

It's no secret that health disparities exist in this country.

African-American and hispanics are more likely than whites to die at an earlier age and develop diseases such as diabetes and high blood pressure.

These inequities among the races will be part of a discussion hosted by OSI-Baltimore at 7 p.m., Thursday at the Enoch Pratt Free Library in Baltimore.

Michelle Gourdine, a physician and author of “Reclaiming Our Health: A Guide to African American Wellness,” and Dr. Thomas LaVeist, director of the Johns Hopkins University Center for Health Disparities Solutions, will lead the discussion and offer solutions for closing the inequity gap.

The speakers will also address healthcare reform, which promises to erase many disparities and make access to healthcare available to all.

“If you had an African-American and white person with same same illness, same income and same background, the white patient would get the more advanced treatment," Gourdine said in a recent telephone interview.

She said patients need to take a more active role in keeping themselves healthy. But she said doctors also have to be careful their perceptions of certain races aren't influencing their medical advice.

"These perceptions doctors develop about people and minorities in particular can affect their decision-making in tems of what type of treatment or care they would give to minority patients," Gourdine said.

The event is part of a speaker series sponsored by OSI-Baltimore to get people to talk more openly about race issues.

Posted by Andrea Walker at 3:01 PM | Permalink | Comments (10)
Categories: Health care reform
        

The U.S. Census Bureau released new information today about how many households are living in poverty and going without health care coverage – it’s first full-year accounting since the recession ending in June 2009.

The report found that in 2010, median household income declined, the poverty rare increased and the percentage without health insurance ticked up just a bit but not significantly.

+Real median household income was $49,445, down 2.3 percent from 2009.

+The poverty rate was 15.1 percent, up from 14.3 percent in 2009. That meant 46.2 million people in poverty in 2010, up from 43.6 million in 2009, for the fourth consecutive annual increase and the largest number in 52 years the poverty rate has been published.

+Those without health insurance was 49.9 million, up from 49 million in 2009. The percentage was 16.3 percent, about the same as the year before.

The number of uninsured is expected to rise dramatically in 2014 when exchanges and subsidies become available. Less clear is what will happen to the rate of poverty and incomes.

For more information, go to the census website.

Posted by Meredith Cohn at 1:53 PM | Permalink | Comments (0)
Categories: Health care reform
        

A federal appeals court in Virginia threw out two challenges to the federal health care reform law.

A three-judge panel of the 4th U.S. Court of Appeals made the move today.

But the issue over the constitutionality of the law isn't over yet. Several other suits have been filed across the country with various outcomes from different courts. The issue is likely to go before the Supreme Court.

The big debate is over whether it is constitutional to require people to get healthcare or pay a penalty.

Posted by Andrea Walker at 5:38 PM | Permalink | Comments (4)
Categories: Health care reform
        

The board responsible for setting up Maryland's open insurance market under health care reform has hired an executive director.

The Board of the Maryland Health Benefit Exchange said it has appointed Rebecca Pearce to the job.

Pearce has worked for Kaiser Permanente as a national product director and director of benefit exception administration since 2008. Before that she worked for six years as a product manager and a director of product management at CareFirst BlueCross BlueShield.

The Health Benefit Exchange will operate a competitive marketplace to help consumers and small businesses find affordable insurance options. The marketplace is expected to open in 2014.

The state of Maryland won a $27.7 million grant last week from the Obama administration to set up its health exchange.

Ms. Pearce will start in her new position in mid-September.

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Categories: Health care reform
        

The state of Maryland won a $27.7 million grant Friday from the Obama administration to set up its health exchange, the marketplace where the uninsured will go to buy coverage in 2014.

The funds are part of a $185 million award from the Department of Health and Human Services to 13 states and Washington for the exchanges.

The agency also laid out three proposed rules on enrolling consumers and small businesses in plans, a tax credit for individuals and families and Medicaid eligibility.

In Maryland, which has been moving aggressively to set up its exchange through legislation and policy development, officials said the money will be used to hire personnel or continue planning for the new marketplace.

“This grant is further recognition of Maryland’s national leadership in implementing health care reform in order to reduce costs, expand access, and improve the quality of care for all Marylanders,” said Lt. Governor Anthony Brown, co-chair of the Health Care Reform Coordinating Council, tasked with overseeing the federal health care reform effort in Maryland.  “The Exchange will provide individuals and small businesses with a competitive marketplace offering affordable health insurance options that meet their needs.”

Brown said the federal money means state dollars will not be needed for the exchange. In all, Maryland has received $34.4 million in federal funds.

Analysts expect health care reform to save the state $850 million and halve the number of uninsured by 2020, though the federal law is being challenged in court as unconstitutional for requiring individuals to buy insurance. The matter is expected to be settled by the Supreme Court, though states including Maryland are moving ahead with implementation.

“One step at a time, we are making progress towards a healthier Maryland,” said Dr. Joshua M. Sharfstein, secretary of the Department of Health and Mental Hygiene and chair of the Exchange Board. “Maryland’s Health Benefit Exchange will continue to engage with many partners to provide new access, affordability, and better health outcomes for Marylanders.”

Posted by Meredith Cohn at 1:10 PM | Permalink | Comments (13)
Categories: Health care reform
        

Patients and their physicians stand to benefit from the health care reform law’s mandate that individuals buy health insurance, says Dr. Edward Miller, dean and chief executive of Johns Hopkins Medicine, and Scott A. Berkowitz, assistant professor of medicine and medical director for Accountable Care for Hopkins.

The pair made the comments in a commentary in this week’s Journal of the American Medical Association.

The mandate has proved to be the most controversial aspect of the reform law, and has been challenged as unconstitutional. The outcome is expected to be decided by the Supreme Court.

But Miller and Berkowitz say the impact on quality and cost of care and impacts on patients and physicians has been ignored in the debate. But they say it would strengthen the patient-physician relationship, increase access to health insurance coverage, stabilize insurance premiums and eliminate “free riding,” when people who can afford coverage do no purchase it but still receive health care. 

“It should be clear to objective observers that the manner in which our nation has historically dealt with health care insurance coverage is unfair, inequitable and unsustainable,” said Miller in the commentary. “Ensuring that the maximum number of people possible have health insurance is crucial in improving access to, and the quality of, care.”

Berkowitz added, “The potential positive impact of the individual mandate on the patient-physician relationship is underappreciated. We know from research that patients with insurance are more likely to have physicians routinely involved in coordinating their care, are more apt to receive regular screening and preventative services and have an increased life expectancy.”

By adding many healthy people to the system, the mandate should also reduce the cost of routine services and provide some financial security.

The two note that in 2008, $73 billion in uncompensated health care was provided around the country, which meant an approximately $1,000 increase in annual family health insurance premiums. With the mandate, the costs will be spread around to more people, since just about everyone uses the health care system in their lifetimes.

So, do you think to continue providing some care for everyone, everyone should have to buy insurance they can afford? Should you be able to opt out of care of all kinds if you don’t want to pay?

Posted by Meredith Cohn at 4:05 PM | Permalink | Comments (2)
Categories: Health care reform
        

Many people living in West Baltimore don’t have health insurance, but some health care providers want to change that and plan a study that will guide development of a primary care delivery system.

Among those participating are Bon Secours Hospital and the Mid-Atlantic Association of Community Health Centers, as well as state Sen. Verna Jones-Rodwell, who represents the city, and John Snow Inc., a health care research and consulting firm.

The study kick off will be Thursday and will be funded in part by a grant from Kaiser Permanente of the Mid-Atlantic States.

The study emerged from a West Baltimore Health Care Summit, which brought hospitals, community health center, charity and community groups together in early 2010 to talk about the challenges in providing care and the role of everyone in improving health.

We'll provide details on the outcome when we get them.

Does the city need more summits? More efforts to hook disadvantaged neighborhoods with primary care? 

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

Health insurers will have to provide birth control to women for free under policies that start next fall, according to new rules from the Obama administration.

The rules were developed by the Health and Human Services Department as part of heath care reform and include other preventive measures (here are all the guidelines). The well-respected Institute of Medicine had recommended the change recently.

Health Secretary Kalthleen Sebelius said all of the items included were preventive:

“The Affordable Care Act helps stop health problems before they start,” she said in a statement.  “These historic guidelines are based on science and existing literature and will help ensure women get the preventive health benefits they need.”

Here's a full story by Reuters.

Groups like Planned Parenthood support the change, citing estimates that half of all pregnancies are unplanned. But religious organizations oppose the move.

Where do you stand?

Posted by Meredith Cohn at 3:56 PM | Permalink | Comments (5)
Categories: Health care reform
        

The Institute of Medicine is recommending that eight more preventive health services for women be added to the list health plans will have to cover at no cost to patients because of health care reform.

Already on the list are breast cancer, diabetes and heart screenings. The U.S. Department of Health and Human Services wanted to find gaps and turned to the institute, an independent panel that offers advice to government policymakers and health professionals. Officials looked at existing guidelines and evidence of the effectiveness of the preventive measures.

Suggested in its report are: screening for gestational diabetes, human papillomavirus (HPV) testing as part of cervical cancer screening for women over 30, counseling on sexually transmitted infections, counseling and screening for HIV, contraceptive methods and counseling to prevent unintended pregnancies, lactation counseling and equipment to promote breast-feeding, screening and counseling to detect and prevent interpersonal and domestic violence, yearly well-woman preventive care visits to obtain recommended preventive services.

“This report provides a road map for improving the health and well-being of women,” said committee chair Linda Rosenstock, dean of University of California, Los Angeles’ School of Public Health, in a statement. “The eight services we identified are necessary to support women's optimal health and well-being. Each recommendation stands on a foundation of evidence supporting its effectiveness.”

Sen. Barbara Mikulski, who sponsored an amendment to the health care legislation that added coverage for other preventive services, applauded the report. She said, the it means, “We are saying hello to an era where decisions about preventive care and screenings are made by a woman and her doctor – not by an insurance company, members of Congress, or a stranger – and women are guaranteed preventive screenings and care with no additional co-pays or deductibles.”

The institute report also recommended that Health and Human Services create a commission to recommend new services over time. It should be separate from the groups that assess evidence of effectiveness – Mikulski’s amendment came after the U.S. Preventive Services Task Force, which makes recommendations to doctors and health systems, said women under 50 years old need not get breast cancer screenings, opening the door for insurers to deny coverage.

Posted by Meredith Cohn at 4:35 PM | Permalink | Comments (1)
Categories: Health care reform
        

The federal government handed down some new regulations outlining how states should manage the exchanges where the uninsured will buy coverage in 2014.

They’re broad and give states wiggle room on naming insurers and controlling premiums, according to this story in the New York Times. But all the states will need a plan by Jan. 2013.

Maryland already passed legislation to set up the public body and board that will oversee the exchange but officials are still working out details. Joshua Sharfstein, secretary of the state Department of Health and Mental Hygiene and chair of the exchange board, said he’s reviewing the regulations to see how they will impact the effort.

“I think we’ve been moving pretty quickly with the exchange to get things set up,” he said. “I think the federal government provided some additional flexibility, which will be very much appreciated by states.”

In addition to setting up the exchange framework, officials have created the Governor’s Office of Health Care Reform and enacted some other consumer protections at the state level, noted Lt. Gov. Anthony Brown, who co-chairs the Health Care Reform Coordinating Council that is overseeing the reform effort. The panel met yesterday and Brown said there has been "real progress in the last six months in our efforts to lower costs, expand access and improve the quality of care for all Marylanders, but our work is just beginning.”

On another health care front that will also impact what people pay for care, Gov. Martin O’Malley has filled four positions on the Health Services Cost Review Commission, the body that sets hospital rates in the state.

The new chair will be John M. Colmers, the former secretary of the Department of Health and Mental Hygiene and the current vice president, Health Care Transformation and Strategic Planning for Johns Hopkins Medicine.

Other members will be Dr. Bernadette C. Loftus, the associate executive director of the Permanente Medical Group; Thomas R. Mullen, president and chief executive officer of Mercy Health Services and Mercy Medical Center; and Jack C. Keane, an experienced health care consultant with expertise in health care payment policy.

Posted by Meredith Cohn at 4:30 PM | Permalink | Comments (0)
Categories: Health care reform
        

The consumer group Maryland PIRG Foundation has outlined in a new report the elements for an effective health insurance exchange, the marketplace where the uninsured will buy coverage under the health care reform law.

The report, called Building a Better Health Care Marketplace, calls for a marketplace run by and for Maryland businesses and consumers. It would need the power to negotiate lower premiums and quality measures. And it would need to be consumer friendly, as well as big and stable.

“Maryland leaders have the flexibility to craft an exchange that enhances choice and competition,” said Jenny Levin, Maryland PIRG Foundation’s state advocate, in a statement. “Consumers need this new exchange to lower costs and improve the quality of their coverage.”

The state legislature approved creation of the exchange this year and officials are waiting for more direction from the federal government on its actual format.

Until 2014, when we get a look at it in operation, are there things you think it should include, allow, forbid or aspire to be?

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

Have questions about health care reform in Maryland or want to hear about effort to improve residents' health?

The Maryland Science Center will host a free public health forum on Monday at 7:30 p.m. related to the reform effort and visions for the future of public health.

The forum is called “Public Policy and Our Health” and will be preceded by a reception for the first 100 registrants at 6:30 p.m. It stems from a traveling exhibit at the center, at 601 Light Street in Baltimore, about diabetes.

On the panel will be:

+Dr. Joshua M. Sharfstein, secretary of the Maryland Department of Health and Mental Hygiene and a former deputy commissioner of the US Food and Drug Administration. He will talk about health care reform in the state and improving access to care for diabetes and other public health issues.

+Dr. Oxiris Barbot, commissioner of health for Baltimore City. She will discuss Healthy Baltimore 2015, an effort to address 10 of the city’s top health problems.

+Dr. Michelle Gourdine, chief executive and principal consultant for Michelle Gourdine and Associates LLC and a clinical assistant professor at the University of Maryland School of Medicine. She will talk about health inequities caused by public policy and cultural and social forces. She will also sign her book, Reclaiming Our Health: A Guide to African American Wellness.

There is no cost, but public participants must register. Send an email with your name and email address to publichealthprogram@marylandsciencecenter.org. Limit four guests per registration. The forum is sponsored by AEGON Transamerica Foundation.

For more information go to www.marylandsciencecenter.org or call 410-685-5225.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Diabetes, Health care reform
        

It's no secret most Republicans are no fans of President Obama's healthcare reform law.

So it came to no surprise that it was heavily criticized during Monday night's GOP debate.

But the presidential hopefuls were fairly muted in their criticism of GOP front runner Mitt Romney, who was governor of Massachusetts when healthcare reform passed there.

They treaded lightly around the subject choosing to attack the president rather than each other. Even Former Minnesota Governor Tim Pawlenty, who this weekend called Romney's healthcare plan "Obamneycare," wouldn't broach the issue.

Romney has defended his plan, in part saying it didn't raise taxes so was different from the federal plan.

What did you all think of the Republicans playing nice with each other? Should this debate have been about the who would be the best GOP candidate and not Obama policies?

What about Romney healthcare plan? Is it really any different than the federal plan?

Give us your thoughts.

Posted by Andrea Walker at 11:43 AM | Permalink | Comments (0)
Categories: Health care reform
        

Gov. Martin O’Malley made his picks for the board that will oversee the state’s new Health Benefit Exchange, where the uninsured will go to buy coverage under health care reform.

Consumers are supposed to be able to compare rates, benefits and quality among insurers. The state passed a law creating the exchange and its structure earlier this year. It will launch in 2014.

The board will include: Dr. Georges Benjamin, executive director of the American Public Health Association; Lisa Dubay, an Urban Institute Senior Fellow; Darrell Gaskin, an associate professor and a health economist at the Johns Hopkins Bloomberg School of Public Health; Jennifer Goldberg,  assistant director of Advocacy for Health Care at the Maryland Legal Aid Bureau; Enrique Martinez-Vidal, vice president at AcademyHealth and director of the Robert Wood Johnson Foundation's State Coverage Initiatives program; and Thomas Saquella, former President of the Maryland Retailers Association.

Three other board members will be the secretary of the Maryland Department of Health & Mental Hygiene, the commissioner of the Maryland Insurance Administration and the executive director of the Maryland Health Care Commission. Dr. Joshua Sharfstein, the health secretary, will serve as the initial chairman.

Continue reading "Panel named to oversee health insurance exchange" »

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

The Maryland Health Care Commission is launching a new web portal to help small businesses compare health care plans.

Called Virtual Compare (http://mhcc.maryland.gov/virtualcompare), it will allow side-by-side comparisons of benefits, premiums and out-of-pocket costs for various HMO and PPO plans. It will also offer guidance about choosing insurance, federal tax credits and state subsidies available to small, low-wage companies (50 employees or less).

Businesses won’t be able to apply for insurance on the site, but they will be get information on 600 brokers who have pre-registered on the site.

“Virtual Compare is an important piece of our commitment to transparency, assuring that information about the quality and cost of health plans and providers is available to the public,” said Marilyn Moon, chair of the Health Care Commission, in a statement.

The portal was the result of 2009 legislation sponsored by Senate Majority Leader Rob Garagiola. He said small business face challenges in choosing insurance for employees.

Employers will be able to compare up to four plans at a time and sort by various features on the portal, designed and developed by Benefitfocus.

If you use the portal, let us know how it goes.

Posted by Meredith Cohn at 10:01 AM | Permalink | Comments (0)
Categories: Health care reform
        

The anniversary of the health care reform law is this week. And to mark the occasion, there will be a free workshop on the particulars sponsored by Baltimore City Community College and Baltimore HealthCare Access Inc., the quasi-public city agency that helps hook low-income residents up with programs.

The event will be held from 12 p.m.-4 p.m. Wednesday at the college’s Liberty Campus Physical Education Center, 2901 Liberty Heights Ave. There will be information on consumer protections and coverage options, as well as free screenings for blood pressure and diabetes, among others.

There will be information specifically for the uninsured, seniors, young adults and those in need of behavioral services.

On hand will be Rep. Elijah Cummings and Dr. Joshua Sharfstein, Maryland Secretary of Health and Mental Hygiene.

“As the new provisions of the Affordable Care Act roll out, many of Baltimore's 96,000 uninsured will have the opportunity to obtain health care coverage and everyone benefits from the new consumer protections,” said Baltimore HealthCare Access President Kathleen Westcoat, in a statement. “But we also know that, particularly in this economy, people need help now so we are pleased to be able to offer some relief.”

She said many of Baltimore’s uninsured may be eligible for health coverage through a Maryland Medical Care program and that onsite enrollment will be provided

There will be free parking on the campus with shuttle bus service to and from the Bon Secours overflow parking lot at 2600 Liberty Heights Ave. A free shuttle will also be available to all seniors through senior services centers in the city. Call Action in Maturity (AIM) at 410-889-7915 for more information on that.

For more information, contact Baltimore HealthCare Access at 410-649-0500.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

Like many members of Congress these days, Rep. John Sarbanes has been on a tour of his district, talking and listening to small businesses, doctors, seniors and other individuals about health care reform.

I got a chance to catch up with him today, just after a press conference remembering Deamonte Driver, the 12-year-old boy who died four years ago when his untreated tooth infection spread to his brain. Rep. Elijah E. Cummings, a fellow Maryland Democrat, held the event at state health offices to stress the need to keep the health care reform law intact.

Sarbanes said (Democratic) members of Congress, some of whom may have wanted to change the subject at election time, are increasingly trying to draw attention to the benefits of the law that includes preventative care measures such as oral care, many at no cost to patients.

Polls show many of those measures are popular, even if the American public is still split on the overall legislation. Those measures include closing the donut hole for seniors on prescription drugs, keeping kids on their parents’ insurance until they are 26, eliminating lifetime benefit caps and preventing insurers from considering preexisting conditions.

And while many GOP leaders say the law is far from affordable for the country, and should be repealed and replaced, Democrats like Sarbanes are trying to drive a different message -- this one about the rising costs to individuals from the current system. 

“I ask people, for those who do have health insurance now, are you really happy with your increases in premiums over last 5 years?” he said.

“They’ve gone up 10, 15, 20 percent,” he said. “We can redesign the system to bring costs down, or make the trajectory not as steep. People say I have health insurance, don’t tinker with it. But if you ask if they are really okay, can they sustain the increases, they think about it.”

Continue reading "Local lawmakers take health care reform on the road" »

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Categories: Health care reform
        

In this story by the New York Times, some of the survivors of the shootings said they have thought about how much of their medical bills they would have to pay.

It turns out that all of the 13 survivors had health insurance, including Rep. Gabrielle Giffords, who has top-of-the-line federal insurance. And there are pots of money, from federal and nonprofit sources, that will help defray other costs, such as travel to the trial and maybe counseling and even new glasses.

The bills aren't all in yet, and surely the victims have copays and deductibles, but the hospitals that treated the survivors say they expect insurance to cover the bulk of the costs.

But what if they didn't have insurance? Should they or their families have to pay a dime now or if a problem arises later?

If they shouldn't have to pay, who should? And what about victims of car crashes or other disasters or accidents -- or in Baltimore, crossfire -- beyond the victims' control? The victims and families of the Sept. 11, 2001, terrorist attacks were compensated, but only recently did Congress step in to provide full medical care for the first responders.

Those who can't pay for medical care are treated anyway, and the public pays either through taxes or higher premiums. There is no "do not treat" list. But many struggle with bills when they get sick or hurt, or whether it's their own fault or not. So, where is the line? 

Reuters photo

Posted by Meredith Cohn at 11:08 AM | Permalink | Comments (0)
Categories: Health care reform
        

As the U.S. Senate debates repeal of the national health care reform law today, the leaders in the states are also contemplating their next moves since a Florida judge rejected the entire reform law  because it unconstitutionally requires every America to buy health insurance.

Some led by Republicans say they will halt preparations for the law, while other conservatives have treaded more gently, according to the Washington Post. In addition to having accepted federal preparation grants that they could have to pay back, the governors also know that if they don’t move forward in creating exchanges where the uninsured can buy coverage, the federal government can do it for them.

But the states led by Democrats, such as Maryland, say they are moving ahead. Gov. Martin O’Malley issued a statement Monday that said: “Today's ruling is one step in a process that will resolve legal challenges to the Affordable Care Act. While the courts do their work, Maryland will continue to move forward with the act's successful implementation.

“This law is strengthening insurance for all Marylanders with coverage, will extend coverage to more than 350,000 Marylanders, and will save the state more than $800 million by 2020.”

The constitutionality of the law is likely to be decided by the U.S. Supreme Court in the next couple of years. Read a Reuters story about the legal argument here.

The population appears split on the subject of the overall law. Many fear it’s too expensive to give so many more people coverage or, like two of four judges who have ruled so far, object to the individual mandate. But many of the individual items in the law are popular, such as free preventative care, additional drug coverage for seniors, coverage for young adults on their parents’ plans and a ban on lifetime benefits and consideration of preexisting conditions.

Meanwhile, the newly Republican led House already voted to repeal the law. The Senate may take a (most certainly unsuccessful) vote today on repeal.

So what do you think the local and federal leaders should do now?

Reuters photo

Posted by Meredith Cohn at 11:20 AM | Permalink | Comments (1)
Categories: Health care reform
        

As many as 129 million Americans under 65 have a pre-existing medical condition -- some 2.5 million in Maryland -- that could cost them their health insurance if the health reform law is repealed, the Obama administration warned in a report today.

Having a medical problems like heart disease, high blood pressure and asthma could drive up the cost of purchasing care, or cause people to be be rejected by insurers all together, according to the study by the Department of Health and Human Services.

The administration released the analysis, a first attempt to qualify the number of Americans with pre-existing conditions, to coincide with Republican efforts today to debate repeal the sweeping health care overhaul passed last year.

The report also includes detailed estimates at the cost of repeal in each state. Here's Maryland's.

Maryland Gov. Martin O'Malley joined the administration's assault on the repeal in a conference call with health Secretary Kathleen Sebelius.

O'Malley said without reform health care costs would continue to rise. Those soaring costs have been a huge drain on businesses, stifling the economy, he said. 

"There is no way our business can expand if we are watching health care costs rise by 50 percent and wages stay stagnant," he said.

O'Malley said Maryland is looking forward to implementing the health care law. In fact, just last week, a state panel gave O'Malley a 16-point plan with recommendations on how to roll out health reform in the state.

"We firmly believe in Maryland that this is important, not only to create more affordable more comprehensive health care for all, but we see this as an opportunity to make our economy more competitive," O'Malley said.

Continue reading "Obama Administration: 2.5 million Marylanders could lose coverage if health reform is repealed" »

Posted by Kelly Brewington at 4:13 PM | Permalink | Comments (3)
Categories: Health care reform
        

Confused about health care reform? "What does it mean for me?" you ask? 

Baltimore HealthCare Access, a nonprofit that connects city residents with medical care programs in Maryland, aims to offer answers with a community forum tomorrow.

The free event, called "Baltimore Health Care Now and Later," will kick off with remarks from Mayor Stephanie Rawlings-Blake and feature forums tailored to seniors, business owners and general health care consumers. The first in series of quarterly community-outreach events, the program aims to inform consumers about their health care options and clear up misconceptions about the sweeping national health care overhaul passed last year.

“It’s really going to be a major shift in how health care is done in this country and people need to be aware of this,” said Therese McIntyre, a spokeswoman with Baltimore HealthCare Access. “They need to know how important this law is and what the facts really are.”

The event also features health screenings, games for children and will highlight elements of the health care reform law that are available to consumers now. It takes place from 1 p.m. to 6 p.m. at the Harry & Jeanette Weinberg YMCA, 900. E. 33rd St., Baltimore. For more information: www.bhca.org  or call 410-649-0500.

Worried that the forum takes place at the same time as the Ravens big playoff match up against the Steelers? Not to fret. The kind folks at Baltimore HealthCare Access plan to set up a 52-inch screen to show the game during the health fair. Nice.

Posted by Kelly Brewington at 10:23 AM | Permalink | Comments (0)
Categories: Health care reform
        

As Congressional Republicans vow to repeal the sweeping health care reform legislation, a consumer group warns doing so could have pricey consequences in Maryland.

Repealing health reform would hurt Marylanders with higher premiums, coverage denials for people with pre-existing medical conditions and increase state employer health care costs, according to study out today by the nonprofit consumer group Maryland PIRG.

The health care exchanges established by the legislation, designed to give consumers bargaining power when purchasing their own insurance, would disappear, forcing individuals to pay higher prices for coverage, the report states. Without the exchanges, individual premiums could go up by 20 percent by 2016, says the report The Cost of Repeal: Examining the Impact on Maryland of Repealing the New Federal Health Care Law.

Small businesses, already struggling to extend health care to their employees, would lose tax-credits to make health care costs more affordable, the report found. Employer-based health insurance could jump by $3,000 a year, the report estimates. And without the savings that health care reform, businesses would create nearly 5,000 fewer jobs by the end of the decade, the report found.

Repealing the law would mean $9.1 billion less in federal Medicaid and put the state’s 126 community health centers in peril, the report suggests.

Repeal would undo key elements of the legislation that aim to get rid of discrimination by insurers, resulting in women paying higher premiums than men and insurers denying coverage to sicker patients, the report states. In addition, some 18,000 young adults in Maryland would lose the ability to stay covered under their parents’ plans.

Whether reform costs money or saves it has been a hotly debated point of late. This NYT piece takes a look at the battle -- over the math. 

Meanwhile, here in Maryland, officials are taking big leaps toward enacting health reform. Check out Meredith's story today about the plans. 

Posted by Kelly Brewington at 2:10 PM | Permalink | Comments (1)
Categories: Health care reform
        

When it come to health care reform, Maryland officials have prided themselves on being ahead of the game – in adding thousands to the ranks of the insured and in setting up the framework that will enable more to get coverage.

So, it’s probably no surprise that Gov. Martin O’Malley has not signed onto lawsuits against the new law. A judge in Virginia recently bucked other rulings and said it is unconstitutional to mandate that individuals buy insurance, a central tenet of reform.

Many legal experts have said the matter will be decided in the Supreme Court, and today O’Malley sent a letter to the governor of Virginia saying he would not sign onto a request from him to expedite the high court’s review.

“We have a difference of opinion on the underlying issue,” O’Malley wrote to Virginia Gov. Robert F. McDonnell, after apparently, the two spoke on the phone about the matter.

“I believe that affordable healthcare for all Americans regardless of pre-existing conditions will strengthen our nation and make America more competitive in the new global economy.

"Most of the judicial opinions arising out of these nuisance cases are actually upholding the law. And on the narrow issue of personal responsibility, I believe that too will be upheld – just as mandatory automobile insurance coverage has been upheld in years past in your state and mine.”

How do you think the court will decide?

Posted by Meredith Cohn at 1:51 PM | Permalink | Comments (0)
Categories: Health care reform
        

A judge in Virginia has become the first to strike down the federal health care law. U.S. District Judge Henry Hudson said it was unconstitutional.

Two others have upheld the law, and today's ruling is certain to be appealed by the Obama administration. And most observers agree that the Supreme Court will eventually decide the case. 

The opposition is coming from some states, but Republicans in Congress also have pledged to change portions or all of the legislation passed last year aimed at covering millions more Americans.

They especially take issue with the mandate that everyone buy insurance. Democrats are trying to stop people from buying insurance only when they get sick, or burdening the system with uncompensated care that drives up the costs for everyone else. A bigger pool of healthy insured people will mean lower costs for everyone, they say.

Republicans say the government doesn’t have the right to require Americans to buy health insurance, even if hospitals are required to treat them when they are sick. They also say the subsidies to help them pay will be too expensive.

The Richmond judge was ruling on the constitutionality.

Also, in Washington, Republicans have blocked attempts to repeal of an unpopular provision in the health law that would require small businesses to meet a lot of new reporting requirements. Democrats tried to attach it to the tax package Republicans negotiated with President Obama, but the Republicans don't want to amend that deal though they oppose the small business measure.

So, for now, nothing changes in the health law. Do you think it's unconstitutional? People still need care, so what can control the uncompensated costs?

Posted by Meredith Cohn at 11:21 AM | Permalink | Comments (1)
Categories: Health care reform
        

According to an account from a Capitol Hill staffer in Politico, newly elected Maryland congressman Andy Harris -- who ran on an anti-health care reform platform -- wanted to know why it was taking so long for him to get his government-subsidized health care.

He demanded to know during freshman orientation why his government health care wouldn't kick in for a month, according to the account. It starts in February, a month after he's sworn in, something he says is unusual and, according to one of his staffers, inefficient.

He ousted the Eastern Shore Democrat Frank Kratovil even though he voted against the health care reform package. Harris wants to repeal the law. 

The staffer said Harris asked if he could buy insurance from the government to cover the month-long gap, and Politico said the aide "was struck by the similarity to Harris’s request and the public option he denounced as a gateway to socialized medicine."

So, is this a non-issue for a congressman intitled to insurance coverage from the government because he'll be working for the government? Or is Harris demanding generous health care benefits that he doesn't think other American's (employed or not) should enjoy?

Associated Press photo

Posted by Meredith Cohn at 12:05 PM | Permalink | Comments (25)
Categories: Health care reform
        

Many conservatives running for Congress, including many who won, say they want to revisit health care reform – repeal or tweak or defund or something.

Americans do remain split on the legislation overall – CNN said exit polls showed half want it repealed and the other half want it expanded or maintained.

Though, advocates point out that many of the individual elements remain popular, such as keeping kids up to 26 on their parent’s health insurance, closing the Medicare prescription benefit “donut hole,” banning insurers from bumping those who get sick out of coverage and not covering kids with pre-existing conditions.

It seems the part many have a problem with is the mandatory coverage for everyone, mainly because of the costs. Though, the advocates say putting so many more people in the system spreads the risk and makes the other provisions possible.

Those advocates, including Health Care for America Now, said they believe the election hinged more on the economy than health care. The group points to a CNN poll that found only 19 percent of voters named health care as their top concern, second, and well behind, the 61 percent who said it was the economy that was most important.

The group also pointed to Politico's assessment that 22 of the 34 Democrats who voted against the health care legislation still lost, as well as three of five senators. Certainly, few even mentioned the legislation on the campaign trail, and many of those who did were running away from it.

For sure, not all lawmakers are anti-health care reform. Senate Majority Leader Harry Reid, who won reelection to his post, says he doesn't want the legislation dismantled. And Maryland officials, led by Gov. Martin O'Malley and Lt. Gov. Anthony Brown, have embraced health care reform.

So, what do you want the new Congress to do with health care?

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (63)
Categories: Health care reform
        

Insurance companies around the country have been dropping health insurance policies that would cover only children.

But in Maryland, two of the state's largest insurance companies are assuring people they will continue to offer child-only policies until healthcare reform takes affect in 2014.

Kaiser Permanente of the Mid-Atlantic and CareFirst BlueCross BlueShield said this afternoon they will offer the policies, often used by parents who may not have coverage through work.

Healthcare reform made it illegal for insurance companies to deny coverage to children with pre-existing conditions after September of this year, but does not require all companies to offer policies.

Some insurance companies throughout the country have refused to sell child-only insurance policies because they think parents will only look for coverage when their children are sick.

The child-only policies only account for 2 percent of the individual insurance market but can be crucial to families who do not have access to family coverage. Parents whose employers don't offer insurance may want to buy an individual policy for their children so at least somebody in the household is covered.

The Maryland Insurance Administration said it is putting emergency regulations in place so that the child-only policies will be offered in two open enrollment periods in January and July until 2014.

CareFirst said in a statement that limiting applications to certain periods would discourage parents from waiting to enroll their children until they needed medical care, which runs up costs.

Posted by Andrea Walker at 2:20 PM | Permalink | Comments (0)
Categories: Health care reform
        

Among the big questions – and controversies – revolving around the new health care reform law, are how many people who can’t afford coverage will get subsidies and how much they will get.

A new report from reform advocates Families USA shows that more than 400,000 people in Maryland will get a tax credit in 2014 to help pay for health insurance. Collectively, their tax bill will be reduced by $1.5 billion.

Nationally, taxes are expected to be reduced by $110 billion in 2014, according to the report.

Among those slated to get a credit in the state, about 202,000 are uninsured and another 211,400 have insurance but have trouble paying for it. The majority, almost 361,000, are in families with a member working full time.

The credits will be awarded on a sliding scale, with lower income people getting more than middle income people. A family of four would be eligible, for example, if they earn between $29,327 and $88,200. Those with the even lower incomes will be added to Medicaid roles.

“This is the largest middle-income tax cut in history, and it will enable many hard-working Marylanders to afford health insurance premiums that have stretched family budgets,” said Ron Pollack, executive director of Families USA, in a conference call to reporters. “The tax cut will not only put significant extra cash in Marylanders’ pocketbooks, but it will also ease the burden of families’ growing health care costs.”

He refuted claims by Republicans that the reform law in general would increase the debt and end up costing other Americans more in insurance premiums. Pollack said more people with insurance will mean less uncompensated care and lower premiums for everyone. Efficiencies in the public health systems also will lower the overall cost of the program.

Many Americans still do not support the new health care law, however, and Republicans have vowed to defund it or repeal at least parts of it.

Posted by Meredith Cohn at 1:09 PM | Permalink | Comments (0)
Categories: Health care reform
        

Maryland will get $3.9 million to increase the primary care workforce as part of funding provided under the new health care reform law.

The money is part of $320 million in grants the federal Health and Human Services agency announced they were doling out to states to strengthen and expand the health care workforce.

"These grants are the most comprehensive yet in addressing our nation's shortage of key health professionals," Mary K. Wakefield, administrator of the Health Resources and Services Administration, said in a statement.

The money will be used to expand primary care residency programs, increase physician assistant training and expand the training of nurse practitioners and midwives among other things.

Posted by Andrea Walker at 5:05 PM | Permalink | Comments (0)
Categories: Health care reform
        

Navigating the health care system can be overwhelming, especially when someone becomes sick suddenly.

But included in the health care law are grants to help senior, those with disabilities and their caregivers understand their health and long-term care options.

Maryland is slated to get $1.7 million of the $68 million in federal funding, the Department of Health and Human Services announced Monday.

“We know how difficult it can be for individuals and caregivers to deal with a sudden illness or chronic disease while at the same time trying to navigate through a complex health care system to figure out where to go to get appropriate help,” said HHS Secretary Kathleen Sebelius, in a statement. “The Affordable Care Act seeks to give people more control over their own care, while lowering health care costs and improving quality.”

The money will be used to help people understand Medicare and Medicaid benefits, including preventative services; understand long-term care options including those that help people stay in their homes; and assist those who are returning home after a stay in nursing or rehab facilities.

More information on the funding at aoa.gov.  

Posted by Meredith Cohn at 5:09 PM | Permalink | Comments (0)
Categories: Health care reform
        

While Republicans in Congress pledge to repeal the national health care reform law, others in Maryland are giving it a warm reception.

State officials joined Towson University students and staff, as well as students from others schools and union members, to cheer for new provisions going into effect today. It was one of about 100 such rallies scheduled around the nation, including an afternoon rally at the University of Maryland in College Park with the U.S. Surgeon General.

At the forefront of this rally, hosted by the advocacy group Maryland Citizens’ Health Initiative, was the provision allowing young adults to stay on their parents’ insurance until they are 26. The state already has a law allowing kids up to 25 to stay on their parents’ plans, but the federal law adds a year and adds new groups of people whose parents’ work for self-insured companies or the federal government. It also adds those not legally dependent on their parents and married kids.

Other provisions kick in today also. Insurers can’t rescind coverage when someone gets sick, they can’t consider pre-existing conditions of children and can’t charge co-pays for preventative care such as mammograms and colonoscopies. The Medicare “donut hole” is beginning to close for seniors’ prescription drug plans and small business already are eligible for tax breaks for providing care.

The nation is split on the overall law, according to polls, providing fodder for an election year. Even some Democrats are backing away from the law, considered too costly to many during tough economic times.

But local officials say these provisions are popular and will help sell the bill to skeptical Americans.
“There was debate, there is debate and there will be debate on the efficacy of health reform,” said Lt. Gov. Anthony Brown, at the Towson rally. “But we know we couldn’t do nothing.”

Brown said in Maryland health care is considered a right, and the state is working to expand coverage to the uninsured and protections for those who already have coverage.

Several students attended the rally, including several that planned to continue on their parents’ plans after graduation or while in graduate school.

Towson University graduate student Tamisha Jackson speaks at a press conference at the student union regarding the law allowing young adults to remain on their parents' health insurance until age 26.  Also in attendance were Lt. Gov. Anthony Brown (right) Vincent DeMarco of Health Care For All, (in background) several college students and administrative staff from the university. Baltimore Sun photo by Barbara Haddock Taylor.

Posted by Meredith Cohn at 1:30 PM | Permalink | Comments (0)
Categories: Health care reform
        

A new report from the U.S. Census Bureau shows that more Americans are living in poverty and more lack health insurance.

The report, called "Income, Poverty and Health Insurance Coverage in the United States: 2009," found the median household income was $49,777, about the same as 2008.

But it found that 43.6 million people were living in poverty, up from 13.2 million the year before, and the official poverty rate grew to 14.3 percent, up from 13.2 percent the year before. It was the third annual increase in a row.

The number of people without health insurance is also on the rise. It was 50.7 million last year and 46.3 million the year before -- or 16.7 percent versus 15.4 percent.

A sign of the times?  

Posted by Meredith Cohn at 3:29 PM | Permalink | Comments (1)
Categories: Health care reform
        

A new study shows small businesses that employ 16.6 million people could be eligible for tax credits afforded in the national health care reform law.

The credits are supposed to offset health insurance premium costs and help the businesses get and keep health insurance, according to the study by the Commonwealth Fund, an independent health policy research foundation.

And the credits are available this tax year, the first of the direct subsidies included in the law. Some 3.4 million workers are estimated to take advantage of the credit by 2013. The credits increase in value the next  year, up from 35 percent of the employer’s premium contribution to up to 50 percent.

The relief is needed at these small businesses, according to the report, called Realizing the Potential of Health Reform: Small Businesses and the Affordable Care Act of 2010. Coverage provided from such firms has eroded over the last decade. While 98 percent of companies with 200 or more employees offer health insurance, only 46 percent of companies with fewer than 10 employees do.

Just over have of those who work for companies with fewer than 50 employees are uninsured or underinsured.

The report notes that the Congressional Budget Office estimates that small businesses could get $40 billion in credits in the next decade and reduce the premiums they pay 8 to 11 percent by 2016. Other provisions in the law will help reduce administrative spending and increase competition among insurers in the insurance exchanges that will be created, the report says.

“The Affordable Care Act is a big step forward for small businesses and their employees,” said Commonwealth Fund President Karen Davis in a statement. “Not only will business owners see immediate benefits from the tax credits, but owners and employees alike will be protected from steep premium increases and high out-of-pocket costs, ensuring they will have access to the stable, secure health insurance they deserve.”

The tax credits are determined by the businesses’ size and average wage. Employers must pay at least 50 percent of their employees’ premiums. The report says, for example, a firm with 10 or fewer workers with an average wage of $25,000 or less would qualify for the maximum 35 percent credit. Rules for applying for the credit are at www.irs.gov.

Will your business or employer apply?

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

Returning to work after having a baby can be a challenge in general, but what about breastfeeding?

The American Academy of Pediatrics recommends breastfeeding for at least a year. And the state says a few area hospitals are making it easier for new moms to stay on schedule.

The Maryland Department of Health and Mental Hygiene is honoring Greater Baltimore Medical Center, Anne Arundel Medical Center and Johns Hopkins Hospital for programs and policies that support the practice after the moms return to work.

Their “Breastfeeding-Friendly Workplace” provides short breaks and a private space for the mothers to pump and store breast milk among other programs. (Those two provisions are now required by the new health care reform law, though employers don’t have to pay for the time and small companies are exempt if it would cause an undue hardship.)

Health and Mental Hygiene Secretary John M. Colmers said there are benefits to companies to aid new moms: Parental absenteeism is lower and so are healthcare costs because breastfed infants are sick less often. He said studies estimate a $400 savings on health care in baby’s first year. It’s not bad for morale and productivity, too, he said.

Colmers points to a U.S. Department of Labor stat: nearly three-quarters of all mothers are in the work force, including 60 percent of mothers of very young children.

The state health department can offer guidance. Find more information on setting up support programs at work or an application for the workplace award at www.marylandbreastfeeding.org.

So, what's the situation in your office?

Baltimore Sun file photo/Chiaki Kawajiri

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (3)
Categories: Business of health, General Health, Health care reform
        

An effort this summer to win endorsements from General Assembly candidates for an alcohol tax has yielded 140 signatures, potentially giving the tax it's best chance of passing in years, according to the health advocacy group Maryland Citizens’ Health Initiative.

The group wants passage of a “dime a drink” tax to pay for increased health care for the disabled and poor. An estimated $249 million would be generated from such a tax.

Letters asking for endorsement were sent to all candidates for the legislature, though not the gubernatorial candidates. Among those signing the pledge were 18 incumbent Senators and 45 incumbent members of the House of Delegates, including five standing committee chairs and several members of the panels that would consider the legislation. Others who did not sign on have said they support raising the alcohol tax if it’s tied to increasing health care coverage. 

Lawmakers have avoiding raising taxes on spirits since 1955 and have not been raised on wine and beer since 1972. The tax, assessed at the wholesale level, would mean an extra 60 cents for a 6-pack of beer, 59 cents for a bottle of wine and $2.25 for an average bottle of spirits.

Though few want to talk about raising tax during a campaign season, and others have pledged no new taxes during an economic downturn, the health care group hopes to make the tax a campaign issue.

“We are thrilled that so many candidates, including Democrats and Republicans from all across the State, have already endorsed this life-saving proposal,” Vincent DeMarco, president of the Maryland Citizens’ Health Initiative, said in a statement. “They know that the public strongly supports increasing the alcohol tax to save lives and fund critical state programs. With this growing support, we are very hopeful that a dime a drink alcohol tax increase for health care and community service needs will pass
in the 2011 Session.”

DeMarco said the money specifically should be used ahead of the national roll out of health care reform to provide coverage for those with mental health and developmental disabilities, those with drug and alcohol addiction and poor adults without children.

The health care group also says that the tax should help reduce alcohol abuse. A Johns Hopkins University Bloomberg School of Public Health study found that the 10-cent tax would mean 15,000 fewer cases of alcohol dependence.

Associated Press photo

Posted by Meredith Cohn at 5:50 PM | Permalink | Comments (0)
Categories: Business of health, Health care reform
        

Advocacy group Maryland Health Care For All! Coalition released a book today chronicling the stories of 40 people or families who have benefited from changes in the state's healthcare policies in the last several years.

The book, "Faces of Maryland's Newly Insured," looks at people who have gotten access to insurance through reform made in the state's healthcare system since 2007.

Some of the changes include legislation that expanded coverage to low-income adults and grants to small businesses to offer coverage to their employees. A cigarette tax funded many of the changes.

The stories include that of Linda of Central Maryland who was able to get insurance for her whole family under the Medical Assistance for Families program and the Maryland Children's Health Program after her husband lost his job.

Louis of Central Maryland gets help paying his monthly prescription premium through the Maryland Senior Drug Assistance Program. Melanie from Baltimore got coverage for her children through the Maryland Children's Health Program after her husband lost his job.

The release of the book comes out as state officials are hammering out how to implement national reform, most of which takes affect in 2014.

"These stories are a testament to the success of health care reform in Maryland," said Vincent DeMarco, President of the Maryland Citizens' Health Initiative. "We look forward to building on this success as we fully implement federal health reform in our State."

Posted by Andrea Walker at 11:49 AM | Permalink | Comments (2)
Categories: Health care reform
        

Maryland is one of 45 states that will recieve $1 million in federal funding to help control excessive hikes in health insurance premiums.

The U.S. Department of Health and Human Services announced Monday it was doling out $46 million as part of federal health care reform. The money is the first round of $250 million allocated over five years to help states monitor premiums.

The states had to apply for the funds. Washington is also receiving money.

The agency said insurance companies in many states have raised premiums with little oversight. Premiums have doubled on average during the past years, outpacing wage increases and inflation, the agency said.

High premiums have priced many people out of the health insurance market.

Federal officials say that while 26 states - including Maryland - have the authority to reject increases that seem excessive, many don't have the resources to enforce it.

Under reform, states will create health care exchanges where people can shop for coverage with subsidies, a set up that is expected to drive down premium costs. Premiums are expected to fall 14 to 20 percent under reform, according to the Congressional Budget Office.

The states will use the money to upgrade technology, improve reporting standards by insurance companies, beef up the premium review process and make premium information better available to the public.

Lt. Gov. Anthony Brown said the money will help the state on strides it has already made in maintaining affordable premiums.

"This grant will help us build on our success and identify new and innovative strategies to maintain accessible, affordable and quality care for more of our neighbors," he said in a statement.

The grants are just one way that health reform will help ease the cost of premiums.

Reform will also allow HHS to review excessive premium increases and make them public. Insurers will be required to spend at least 80 percent of premium dollars on medical care services and limit spending on overhead, marketing, CEO salaries a profits.

States will also be able to exclude from the "exchanges" health plans that show a pattern of premiuem increases that are too high.

Posted by Andrea Walker at 3:06 PM | Permalink | Comments (1)
Categories: Health care reform
        

There are nearly 5 million children around the nation – and about 86,000 in Maryland -- who qualify for free and low-income health insurance but are not signed up. Federal officials are looking to change that through a new campaign called “Get Covered. Get in the Game.”

The campaign recognizes that uninsured kids can’t always play sports because their families can’t afford the physical or fear they won’t be able to pay for care if they get hurt. Officials are hoping to leverage the coaches in schools and community centers, as well as school nurses and others, who can identify these kids.

“We’re pushing this now because it’s a good time of year to get the message out as kids are getting ready to go back to school and they’re getting more involved in sports activities,” said Nancy O’Connor, the regional administrator for the Centers for Medicare & Medicaid Services. “We want parents to learn that they can get some very good coverage for their kids that will help them when they go back to school or when they decide to play on a team.”

Maryland is one of seven states involved in the campaign, a pilot program that will be introduced more widely if it’s successful.

There will be a kick-off event in Maryland today at 2 p.m., sponsored by the Centers for Medicare & Medicaid Services and the Boys & Girls Clubs of Metropolitan Baltimore Inc., at the C.C. Jackson Recreation Center in Park Heights -- which is also hosting the last day of summer camp.

Parents don’t typically sign their children up for insurance because they don’t know they qualify, O’Connor said. Some were recently laid off or they were rejected for Medicaid and they don’t know there is another program, she said.

Parents there to pick up their children will be able to provide information about affordable insurance through Medicaid, which covers the poor, and the Maryland Children’s Health Program, which covers children of low-income families who make a little too much to qualify for Medicaid. Regulations are still being written, but both programs are likely to remain once federal health care reform is rolled out in the next couple of years.

Families of four with income up to $66,000 a year are eligible. And once enrolled, the kids get regular doctor and dentist visits, vision and hearing care, hospital care, shots, mental health services and prescription drugs,

Some parents may also qualify for coverage through the state Medical Assistance for Families program.

For more information about the programs go to InsureKidsNow.gov or call 800-456-8900.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

A task force charged with overseeing sweeping federal health care reform in Maryland approved Monday an interim plan that outlines steps to prepare for the changes it will bring.

The plan sets goals such as containing costs while improving quality, expanding the health care work force to meet demands of new patients and making sure reform actually leads to the better health of Maryland residents.

The 12-member Maryland Health Care Reform Coordinating Council voted unanimously to approve the plan. Three members were absent.

Most facets of reform will not take place until 2004, although some other parts will take place a little earlier.

For instance, the state was awarded $85 million in federal funds earlier this month to help immediately insure people with pre-existing conditions. The state is using the money to increase its high-risk pool, which now insures about 20,000 people. The state will start accepting applications for the high-risk pool in August, and people will be able to enroll in September.

Lt. Gov. Anthony Brown said the interim plan helps to set the frame work of what the state will need to do to implement more sweeping elements of reform.

“Because of the enormity of this, we think it is important to spend time on the up-front work to set up a foundation,” Brown said.

Brown co-chairs the coordinating council with John M. Colmers, secretary of state of the Department of Health and Mental Hygiene. The committee also announced chairs of working groups that will come up with concrete ways to implement reform.

For example, one group will look at how to create health care exchanges where people can shop for coverage with subsidies. The state is also looking at creating pilot programs to test out new ways of caring for patients.

The council’s interim report will be officially released Monday. The report will include a cost analysis outlining how much money Maryland taxpayers will save under health care reform. The report will also include an overview of the federal legislation, key points the state needs to address and potential grants and funding opportunities. Some of the suggestions in the report were taken from more than 160 ideas from the public submitted on a state website and during past hearings.

A final report is due to Gov. Martin O’Malley Jan. 1.

State officials have said that they are in better shape than other steps because they already have initiatives for the uninsured, such as its high-risk pool.

Posted by Andrea Walker at 6:40 PM | Permalink | Comments (5)
Categories: Health care reform
        

A realtor associate of mine tried to buy health insurance a few years ago, but was denied time after time because as he bluntly described it "i'm too fat."

He wasn't obese by any means, but would probably admit he could lose a few pounds. Those few pounds were enough of a "preexisting condition" for health insurers to consider him a risk.

He may have a better chance at getting some coverage soon.

The federal government announced today that as part of national healthcare reform it has a new "pre-existing insurance plan" for those with conditions that have prevented them from getting insured. The program is a transitional program that will exist through 2014 when full reform is implemented.

Health reform has provided $5 billion in federal funding to each state to support pre-existing health insurance. Some states will operate their own program, while other states will let the government run theirs.

Maryland is one of the few states that has long offered insurance for high-risk pools, but many complained it was too expensive. Some chose to go without instead.

Maryland will get $85 million in federal funding through 2013 to expand the pool and hopefuly get more people with pre-existing conditions on the health care rolls. It is unclear whether the plans will be cheaper than they are now or if it will just allow more people to get on the rolls.

The Maryland Health Insurance Plan will begin accepting applications in early August and begin enrolling people Sept. 1. The temporary pool will end in 2013 when it will be replaced by federal exchanges.

Look for a follow up blog soon on how people can apply and whether the additional funding will help lower the cost of the high risk plan.

Read more from my colleague Meredith Cohn about healthcare reform in Maryland.

Posted by Andrea Walker at 12:19 PM | Permalink | Comments (1)
Categories: Health care reform
        

In an effort to improve care for Marylanders, and also cut costs, state officials are launching a pilot program that aims to involves 200 primary care doctors and 200,000 patients.

Called the Patient Centered Medical Home program, it will give incentives to doctors to spend more time with patients, coordinate their care across the health care system and promote prevention and wellness, according to Lt. Gov. Anthony G. Brown, who co-chairs the panel inplementing health reform in Maryland and has been working on changes to the state's system of care.

The pilot is the result of legislation passed by the state legislature this year and is based on programs already running throughout the nation that report high patient and provider satisfaction.

The doctors will offer enhanced access, expanded hours and telephone and email communications. The goal of the prevention emphasis is improved quality of care and fewer emergency department visits and expensive hospitalizations.

The primary care providers will receive a fee from participating insurers for each patient to cover the extra care, in addition to their regular fee-for-service payments, and they will have a chance for additional compensation if there are savings from improved health.

Health and Mental Hygiene Secretary John M. Colmers said the three-year program will help change the way care is delivered.

It will launch in January 2011. Members of the Maryland Health Care Commission have begun talking to doctors about participating. Patients can talk to their doctors about signing up their practices.

For more information, go to the PCMH Pilot website  or send an email to:pcmhpractices@mhcc.state.md.us.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

As of today, 74 members of the U.S. House of Representatives have signed on to a discharge petition in an effort to force a vote to repeal the federal health care reform law.

The lawmakers are pretty far off from the needed 218 names and repeal is a longshot. But the move is getting praise from various conservative groups, including the Heritage Foundation and the Club for Growth. They promise to make this a campaign issue.

“The American people are looking for bold leadership,” said Heritage Action Chief Exective Michael A. Needham in a statement.  “These thirty Members of Congress are providing that leadership and deserve to be praised for getting out in front on this issue.  I fully expect more members to sign the discharge petition as the pressure for repeal continues to build.”
 
The groups believe the law will become far too costly, especially during such tough economic times.

The bill aims to provide coverage for 30 million uninsured Americans and guarantee coverage and standards of care for everone else -- so if you lose your job and become uninsured you'll be able to find affordable insurance.

No Maryland lawmaker has signed on to the repeal effort. The list of those on the petition are on the next page.

So, should the law stay on the books? Will it increase, rather than decrease, the deficit as promised? Will it be worth it? Will this be the major campaign issue?

Continue reading "UPDATE: Lawmakers sign on for repeal of health care reform" »

Posted by Meredith Cohn at 3:00 PM | Permalink | Comments (0)
Categories: Health care reform
        

While most parts of a sweeping national health care reform won’t take effect until 2014, the government is giving small businesses incentives this year to get people on the insurance rolls.

Many employers are already taking advantage of a tax credit they can get for 2010 if they offer their employees insurance, according to small business advocates.

The employers have to have fewer than 25 full-time employees with annual salaries of less than $50,000 to qualify. They also must contribute at least 50 percent of each employee’s premium.

The smallest businesses often struggle the hardest to offer their employees health insurance — even if they’d like to. In Maryland, just 56 percent of firms with fewer than 50 employees offer workers health benefits, according to the Kaiser Family Foundation.

The subject was part of the discussion during a health care forum held last week at Johns Hopkins University. Among the representatives fielding questions was the group Small Business Majority, which advocates for firms with fewer than 100 employees.

"Small businesses want their workers to have health insurance," said Terry Gardiner, national policy director for Small Business Majority. "They just have to be able to afford to do it."

The tax credit for small businesses is one of the first pieces of the reform law to take effect. The credit is offered on a sliding scale basis of up to 35 percent of the employer’s eligible premium expenses through 2013. The credit will be taken on the annual tax return.

Small Business Majority has a nifty tax credit calculator on their website: http://smallbusinessmajority.org/tax-credit-calculator/

After 2014, the maximum credit increases to 50 percent of premium expenses, but coverage must be purchased from state health insurance exchanges.

Small businesses will pool their buying power in these exchanges to negotiate better rates. Right now small businesses pay premiums that on average are 18 percent higher than large businesses, and the smaller firms pay administrative costs built into their health plans that can be three to four times as much, according to the Small Business Administration. All because they don't have enough clout with insurers.

Nearly 13 percent of workers at U.S. firms with fewer than 10 employees paid annual premiums of $7,200 or more for coverage for a single person in 2008, according to the Agency for Healthcare Research and Quality. The national average was about $4,700.

The new law also will prohibit insurers from charging higher rates to small businesses with sick employees or raising rates when somebody gets sick.

Advocates of health reform also believe more people may be willing to work for small companies after the changes. Small businesses may not have been able to compete for the top workers because they can't offer competitive health benefits.

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (6)
Categories: Health care reform
        

Got questions about health care reform? 

A panel of experts will discuss the new health care reform law and its impacts on Marylanders today from 11 a.m. to 12:30 p.m. during a public forum at Johns Hopkins University's Turner Auditorium, 720 Rutland Ave.

The forum will also be webcast at www.jhsph.edu/maphtc, if you can't get over there.

There will be representatives from the AARP, Families USA, the Small Business Majority, Maryland Association of Nonprofit Organizations, Maryland Health Care for All! and the MidAtlantic Public Health Training Center.

They'll talk about the law and take questions on consumer protections in the insurance market, the new insurance exchanges, prevention and wellness, employer requirements, Medicare, and Medicaid.

The title of the forum is: “What Does Health Reform Mean for You, Your Business, or Nonprofit?”

For more information, go to http://www.healthcareforall.com.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

It's no news that the doctor ranks are going to be squeezed when millions of new patients have access to insurance under federal health care reform.

The U.S. Department of Health and Human Services announced this week $250 million in investments to increase the number of doctors, particularly primary care physicians, in hopes of easing the problem. The ranks of primary care doctors are already low because many medical students choose specialties that pay more.

But will the funding be enough?

The money will help to create 16,000 new primary care providers over the next 15 years. The Association of American Medical Colleges predicts a shortage of 21,000 primary physicians by 2015.

Here is an allocation of the $250 million:

 - 168 million to train 500 new primary care physicians by 2015

 - $32 million to support the development of 600 new physicians assistants

- $30 million to help more than 600 nursing students attend school full-time instead of part-time 

- $15 million to opearaten 10 nurse-managed healtch centers to train nurse practitioners

- $5 million for states to develop plans to increase the primary care workforce 10 to 25 percent in the next decade

What do doctors and others out there think? Is this a step in the right direction? Is it going to solve the doctor shortage? What else can be done?

Posted by Andrea Walker at 9:31 AM | Permalink | Comments (1)
Categories: Health care reform
        

As reform prepares to provide more people with access to healthcare, the number of people who are uninsured continues to grow.

There were 46.3 million people nationwide, or 15 percent of the population, without health insurance in 2009, according to the Centers of Disease Control and Prevention. Nearly 33 million people had been uninsured for more than a year.

In 2008, 43.8 million people were uninsured.

Massachusetts, which has passed its own version of universal health care coverage, had the lowest percentage of uninsured residents at 3.4 percent. Texas had the highest with 22.9 percent of the population without health coverage.

In Maryland, 1.6 million people, or 13.2 percent of the population were uninsured.

Posted by Andrea Walker at 4:32 PM | Permalink | Comments (1)
Categories: Health care reform
        

The nation's medical schools are not all producing doctors to meet the country's growing health care needs, according to a study by researchers at the George Washington Univeristy published in the June 15 Annals of Internal Medicine.  

On the heels of health care reform legislation that will put millions more people into the ranks of the insured, the study ranked all U.S. medical schools based on their contributions of primary care physicians, doctors serving in underserved areas and minority physicians -- or their ability to meet a social mission.

The researchers found at 141 medical schools:
--Those in the Northeast generally performed poorly on all three measures.
--Public schools graduated higher proportions of primary care physicians than private schools.
--Schools with substantial National Institutes of Health research funding generally produced fewer primary care physicians and physicians practicing in underserved areas. 
--Several large research institutions (University of Minnesota and University of Washington) defied the trend.
--Historically black schools had the highest social mission rankings.
--Osteopathic schools produced more primary care physicians than allopathic schools but trained fewer minorities.
--Schools in progressively smaller cities produced more primary care physicians and physicians who practiced in underserved communities but graduated fewer minorities.

Medical schools are expanding for the first time in three decades, researchers said. And the study shows how they can determine the make-up of the physician workforce.

“Where doctors choose to work, and what specialty they select, are heavily influenced by medical school,” says lead author Dr. Fitzhugh Mullan, professor of health policy at George Washington University. “By recruiting minority students and prioritizing the training of primary care physicians and promoting practice in underserved areas, medical schools will help deliver the health care that Americans desperately need.” 

The study was funded with a grant from the Josiah Macy, Jr. Foundation. The researchers looked at physicians in practice after the completion of all training and national obligations rather than initial residency to get a better picture of where doctors ended up. Data was for graduates from 1999 to 2001.

See the rankings on the next page (Hint: Hopkins didn't rank so high).

Continue reading "Hopkins's social mission questioned in study" »

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

A key element of the health reform bill allows young people to remain on their parents' health care plans until they turn 26. The provision doesn't kick until later this year, but some insurers are expanding coverage now.

Our colleague Eileen Ambrose explains in this piece published yesterday. Major insurers such as WellPoint, CareFirst BlueCross BlueShield, UnitedHealthcare, said they'll would continue coverage for people up to 26, without interruption. 

But what if you lose your insurance before the law kicks in? This was a question a few people had in our live chat a few weeks ago about health care reform. (Take a look at the Q&A for other common questions about how the law will affect you.) 

Young people have a few options, Ambrose explains: They can buy coverage through their parent's plan under COBRA or buy an individual policy -- cheaper ones are available for even a few months.

Got more questions about how reform will affect you? Ask away and we'll get you answers.

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (0)
Categories: Health care reform
        

Here's a new health care controversy out of small-town Florida making a national news splash today. A Central Florida urologist upset about health care reform is telling his Obama-supporting patients that they should look for care somewhere else, the Orlando Sentinel reports.

A sign posted to the office door of Dr. Jack Cassell reads: "If you voted for Obama … seek urologic care elsewhere. Changes to your healthcare begin right now, not in four years."

The doctor insists his stance isn't unethical -- he's not turning patients away. "But if they read the sign and turn the other way, so be it," he told the paper.

Bioethics experts say Cassell is walking a fine line between his obligation to take care of patients and his right to express his views freely.

What do you think? Is the doctor behaving ethically?  

Posted by Kelly Brewington at 3:45 PM | Permalink | Comments (12)
Categories: Health care reform
        

Let's take a time out and talk about some of the numbers in the health care bill, mainly how many people will be covered and how many won't be. While the effort to overhaul the nation's health care system was pitched as a movement to cover the uninsured, millions of them will remain without coverage after the plan is enacted.

Well how many will remain uninsured and who are they, you ask? This piece from Kaiser Health News explains.

The bill covers 32 million people. That leaves some 23 million uninsured, the story explains. Some -- about 7 million are illegal immigrants.

The other 16 million are a mix of people. Some will be exempt from the mandate because they can't afford to buy their own insurance. (People are exempt if the most affordable plan is more than 8 percent of their income) Others would opt out for religious objection. And still others would prefer to pay a penalty than get insurance coverage.

Congress recognized months ago that any bill likely to pass would leave out some people from being covered.

For more details on who the uninsured are, check out this interactive map from NPR from last fall that gives a breakdown by geographic region.

Still confused about when the key elements of reform kick in? Here's a cool chart with timetables from the Kaiser Family Foundation. 

And if you have more questions about how reform will affect you, take a look at our Q&A from earlier this week with Bradley Herring, an assistant professor in health policy and management at the Johns Hopkins Bloomberg School of Public Health.

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

Along with individual mandates and health insurance exchanges, health reform includes a provision to get chain restaurants to list their calorie counts by next year.

Tucked within the sweeping legislation to overhaul the nation's health care system, labeling calorie information will become a requirement of chain restaurants and vending machines with more than 20 locations.

New York City already has such a provision and states such as California and Oregon have measures set to take effect next year. Some studies show labeling leads to people to pick healthier options, while others have found that alone, they do little to curb people's eating habits, the WSJ reports.

Folks at Yale's Rudd Center for Food Policy and Obesity called the provision "an historic development" according to the NY Times, noting that too often people chow down on fast food without realizing how unhealthy it is for them.

Other supporters say such information can be empowering and help all of us make better eating choices. I'll be honest: it's not that I don't realize that Big Macs contain mega calories. It's just, well, perhaps I don't want to know exactly how much. 

How about you?

AP photo

Continue reading "More health reform: calorie counts coming to a McDonald's near you" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (3)
Categories: Diet and exercise, Health care reform
        

We're less than two hours away from our live chat to answer all your burning health care reform questions. Wondering what the individual mandate means? Do you get to keep your insurance? When do the key provisions of the bill kick in?

Join us at noon to get answers from Bradley Herring, an assistant professor in health policy and management at the Johns Hopkins Bloomberg School of Public Health. 

And feel free to start submitting your questions now in the comments space below. See you then!

Posted by Kelly Brewington at 10:04 AM | Permalink | Comments (2)
Categories: Health care reform
        

"What does the health care bill mean to me," you ask? Well, here on the blog tomorrow at noon, we'll have a live chat where you can ask an expert who's been studying this historic legislation.

Bradley Herring, an assistant professor in health policy and management at the Johns Hopkins Bloomberg School of Public Health, will be here to answer questions about how health care reform might affect you. You can submit questions beforehand in the comments below.

Posted by Kate Shatzkin at 1:57 PM | Permalink | Comments (25)
Categories: Health care reform
        

Congress took the historic step to pass a sweeping overhaul of the nation's health care system. Now what does that mean for you, particularly if you're uninsured?

The legislation will extend insurance coverage to 600,000 more Marylanders -- some 63,000 in Baltimore alone, according to an analysis by Baltimore HealthCare Access, a quasi-public agency that helps link low-income people with Medicaid.

Breaking that down further, according to the group's analysis:

--About 309,000 non-elderly low-income people will be eligible for coverage through an expansion of Medicaid--about 32,000 of them in Baltimore.

--The health care plan comes with an individual mandate that requires nearly everyone have coverage, or face a tax penalty. Low and moderate income people can get help through government subsidies to purchase insurance through new health insurance exchanges. In Maryland some 315,000 will be eligible for subsidies, which kick in for people earning up to 400 percent of the federal poverty level. In Baltimore, about 32,000 people would be eligible for such help. For example: a family of three making $54,930 (which is 300 percent of poverty) would qualify for a subsidy to buy a health plan in a new health exchange. The premium to cover that family wouldn't exceed $5,218 or 9.5 percent of their income.

Important note: the expansion of Medicaid, the creation of the health insurance exchanges and the tax penalty don't kick in until 2014.

We'll bring you more analysis on what the bill means for other groups... For now, here's a good Q&A consumer guide from the folks at Kaiser Health News.  

Continue reading "What health care reform means for uninsured Marylanders" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (7)
Categories: Health care reform
        

The recession coupled with rising health care costs has taken a stiff financial toll on most Americans -- but no one more than the middle class, according to a new report from the Robert Wood Johnson Foundation.

The number of middle-income Americans who get health insurance from their employers fell by 3 million people from 2000 to 2008, according to the report called Barely Hanging On: Middle-Class and Uninsured, which offers state data on the issue. Today about 66 percent of people who earn between $45,000 and $85,000 get insurance through their jobs.

In Maryland: 

• The number of middle-income people who were uninsured increased from 160,000 in 2000 to 240,000 in 2008.
  
• About 12 percent of private-sector employees worked for companies that didn't offer health insurance.
  
• Even for those with insurance through their employer, costs are rising. A family insurance policy increased 46 percent from 2000 to $12,651 in 2008.
  

While lower income earners can qualify for Medicaid and people with higher incomes can afford to purchase coverage on their own, those in the middle are getting squeezed, the report explains. If you're middle class you typically don't qualify for government insurance programs, so getting coverage through your employer is often the only feasible option.

The report is part of the organization's effort urging for coverage of the uninsured. It so happens to correspond with this week's big showdown in the House on the health care bill.

Does your employer still offer coverage? How much has your plan increased in recent years? How are you holding up?

Continue reading "Study: Middle class hardest hit by rising insurance costs" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

This morning, 300 Baltimore residents will head to Washington to join other health care reform supporters in a protest against insurance companies.

The group, supported by the public employee and health care worker union AFSCME and the pro-health reform group Health Care for America Now, says they will make a "mass citizens' arrest of the health insurance executives who are denying care, hiking up premiums and contributing to the deaths of 45,000 people each year." 

The group aims to get Congress' attention during the same time  America’s Health Insurance Plans (AHIP), the health insurance lobbying group, is meeting in DC.  That group, for the record, also says it supports health care reform.

According to a press release on the protest, Baltimore residents Dorothy Bryant and others will head to the hotel where the AHIP meeting is planned with arrest warrants, badges, crime tape and “wanted” posters.

“It’s time to put the enemies on notice. We will not allow the big corporations and their lobbyists to bully Congress to a standstill. This means confronting the health insurance industry that has secretly spent tens of millions to protect its profits by trying to kill reform,” said Dorothy Bryant, a member of AFSCME Council 67, in a statement. “I’ve decided that if Congress can’t hear me from Baltimore, then I’m going to DC and making my voice heard.”
 
So, are you getting on the bus? What do you think of this action? Would you go to Washington to support or oppose health care reform?

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (9)
Categories: Health care reform
        

The chattering class is all abuzz about yesterday's unprecedented live TV showdown between Republicans and Democrats at President Obama's health care summit. In case you missed it, here's a general recap and some good resources for understanding what went down.

In a nutshell: Dems and Republicans appear no closer to any compromise on the legislation.

Along the way, there was some tense bickering, mundane discussion of the minutia of reform (check out this glossary by the folks at Slate for a translation of the jargon) and a personal plea by the president to pass reform as he recounted stories of his mother's death of ovarian cancer and his children's past illnesses.

Nearly everyone, it seems, was Tweeting or Facebooking about the day-long debate. Were you?

Politico offers this meaty (and at times hilarious) play-by-play of the entire summit. 

And Politifact combed through the truth from the hyperbole in this lengthy list of fact checks. 

Did you watch? What did you think? Don't let all the journos and talking heads have all the say. Sound off here.

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (6)
Categories: Health care reform
        

According to a story in today's Sun, Congressional leaders are still trying to figure out a way to pass health care reform -- albiet quietly.

Democrats may try and persuade House members to vote for the Senate package and then go back and fix some things later under a budget procedure that is filibuster proof. Or they may seek a scaled down package that can pass both chambers.

But after the loss of former Sen. Ted Kennedy's seat in Massachusetts to a Republican, possibly due in part to voter anger over the economy, Dems are trying to keep the negotiations low key. They'd like to appear to be working full-time on job creation.

Indeed, President Obama barely touched on the subject of health care reform in his State of the Union message. But you can read more about the President's plan and watch a video at whitehouse.gov.

Meanwhile, some medical groups, including the American College of Physicians, are urging lawmakers not to give up on reform this year.

So, what do you think? Did the Dems overreach? Or, should they keep pushing for coverage for the millions who don't have it and protections for those who do?

Associated Press file photo of the State of the Union speech

Posted by Meredith Cohn at 12:00 PM | Permalink | Comments (1)
Categories: Health care reform
        

Everyone's weighing in on the State of the Union address last night in which President Obama chose his words very carefully when discussing health care.

He called it "health insurance reform"-- not health care reform. And he was candid about the political drama that has unfolded since he championed overhauling the nation's health care system: "And by now it should be fairly obvious that I didn't take on health care because it was good politics," he said.

While the president didn't mention health care until 40 minutes into the speech, he made an impassioned plea to his party not to abandon the issue and practically begged lawmakers to try to see past their differences and get a bill passed, explains this AP story. He even pressed Republicans and other naysayers who don't like the bill, to come up with a plan of their own.

He admitted that he didn't do the best job selling reform to the public, but argued that without it, things will only get worse.

I take my share of the blame for not explaining it more clearly to the American people.  And I know that with all the lobbying and horse-trading, the process left most Americans wondering, "What's in it for me?"

But I also know this problem is not going away.  By the time I'm finished speaking tonight, more Americans will have lost their health insurance.  Millions will lose it this year.  Our deficit will grow.  Premiums will go up.  Patients will be denied the care they need.  Small business owners will continue to drop coverage altogether.  I will not walk away from these Americans, and neither should the people in this chamber

You can find the President's full remarks here.

Continue reading "Obama takes on "health insurance reform" in State of the Union" »

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (1)
Categories: Health care reform
        

Nurses can help reduce medical errors, promote wellness, increase efficiency and help hospitals cut costs. But rarely are they seen as important decision makers, not to mention, revenue generators as compared to doctors, according to a new survey from Gallup and the Robert Wood Johnson Foundation.

When it comes to health care reform, nurses have a lot to offer, the survey found. Problem is, they're unlikely to have much influence compared to doctors and insurance and pharmaceutical executives. Seventy-five percent of people polled said government officials will have huge impact on health reform in the next five to ten years. Just 14 percent said nurses would.

"Nurses are highly trusted sources of health care information, but as we look to reform our health system, our nation is not taking advantage of all that nurses have to offer," said Dr. Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation in a statement. "This survey shows that opinion leaders recognize that we are squandering opportunities to learn from nurses and implement their ideas. We must build on the widespread trust of nurses’ expertise as an essential component in leading and implementing reform."

The foundation polled 1,500 people across health care industry, from insurance companies to university faculty for a look at nursing roles. We spoke a lot about that a few weeks ago in the post on depictions of nurses on TV. Well, this survey suggests some of those televised stereotypes are all too common in real life.

Nurses should work to make their voices heard, the report states. Likewise, nurses should be held accountable for taking a lead on health reform. What do you think?

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

With Republican Scott Brown winning Ted Kennedy's Senate seat in Massachusetts last night, the Democrats have lost their filibuster-proof majority, throwing a huge stumbling block in their way to get a health bill to the president's desk. 

So what's the fate of health reform? Well, that's the billion dollar question everyone's trying to figure out today. Here are a few good explanations, so far:

The effort's not dead yet, say some analysts. But the options are few and very complex, says this update from the Politico.

In one backup plan, House Democrats may try to approve the Senate version of the bill. While the bills are similar, there are big differences that could be difficult to iron out, says this story in the WSJ. House lawmakers don't like the Senate version's tax on big insurance plans and smaller subsidies to help low income people buy insurance, to name a few. 

Others offer a gloomier picture. This Slate piece predicts reform doesn't have a hope, and maps out four scenarios for why this is the case.  

Posted by Kelly Brewington at 12:20 PM | Permalink | Comments (2)
Categories: Health care reform
        

The new year brings a new skirmish on the health care reform front. As leaders in the House and the Senate prepare to merge their very different versions of the health care bills, here are some great resources for following the debate:

+   The Kaiser Family Foundation -- not the insurance carrier -- provides a nifty web tool providing side-by-side comparisons of the bills. You can also choose a health care issue, like say, "individual mandate" or "financing" and make your own cheat sheet on how the bills stack up. It's comprehensive, easy to use and has become my favorite tool as I write and research health reform stories.

+   The news agency run by the Kaiser Family Foundation -- Kaiser Health News --provides a solid Q&A on some pressing issues, including: Q: I want health coverage, but can't afford it. How would the legislation affect me?

+   This Associated Press feature offers highlights of the plans and examples how they would impact real people from a 28-year-old single woman who works part time to a 60-year-old married man who is self-employed.

+   Young, healthy and still bristling at the notion of being forced to carry health insurance? Check out The Sun's website for this explanation of why Congress is mandating insurance coverage. Our site also has another helpful breakdown of the highlights of each bill. 

And with that, let the wrangling begin!

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

There are lots of assumptions made about the U.S. health care system and how it differs from say, the British nationalized model. In America, everyone has unfettered access to top-notch drugs, while the Brits ration their care, goes the stereotypes. That leads many critics of U.S. health reform efforts to assume the American system is just fine the way it is.

But a new study by Johns Hopkins researchers finds the perceptions aren't so. The study compares the two systems' access to the most expensive cancer medications and asks: Which is more fair? And which cancer patients are better off?

The study, appearing in Milbank Quarterly, compared the costs of 11 pricey cancer drugs. In the UK, seven are free to all patients, with no out-of-pocket costs. Four aren't because they aren't considered worth the limited benefit. If patients want those drugs, they need to pay up.

Here at home, people with insurance have some coverage of all 11 drugs--but the range of out of pocket costs are enormous, depending on the carrier.

Both systems involve a kind of rationing, concludes the study. And here's something that will make reform foes gasp: The issue isn't whether rationing is good or bad, argues the reports' author, Ruth R. Faden, director of the Johns Hopkins Berman Institute for Bioethics. That's because no system can provide patients every medication or intervention to every patient all the time, she writes.

"The issue is what we should do about extraordinarily expensive treatments, some of which do very little to improve how well or how long people live," said Faden in a statement. At the same time, she adds, "there is no ethically defensible reason why some Americans have access to expensive cancer drugs and some do not."

Continue reading "Who gets expensive cancer drugs? And thoughts on rationing" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Cancer, Health care reform
        

With the Senate in a pinch to meet a Christmas deadline to pass a health reform bill, a new report paints a bleak picture for Maryland if reform doesn't happen.  

Some 482,000 people in Maryland will gain coverage by 2019 under the Senate health reform bill, according to the report by the national consumer advocacy group Families USA. Without it, about 125,000 people in Maryland will lose coverage by that same date.

In 2007 and 2008, the average number of uninsured in Maryland was 715,000, but that figure could rise to 840,000 if the Senate goes home for Christmas without a bill, the report estimates. Nationally, the number of people without insurance could hit 54 million in 2019 without a health care overhaul.

The group, which if you haven't noticed, has been lobbying big time for the Senate to hurry up and pass legislation to expand coverage to millions. It has come out with similar sobering figures on the impact that the status quo could have on the states.

A few months ago, the group released a report estimating that 114,780 people will lose health coverage in Maryland from 2008 through December 2010.

photo courtesy of Brooks Elliot @ flickr

Posted by Kelly Brewington at 12:04 PM | Permalink | Comments (1)
Categories: Health care reform
        

New research puts a number on the cancer risk that the growing number of CT scans can pose patients -- the latest evidence that the scans may be overused.

The 70 million CT scans done in 2007 -- a jump from just 3 million in 1980 (!) -- could ultimately cause 29,000 new cancer cases, according to estimates from the study, which appears in the latest Archives of Internal Medicine. 

Doctors like the scans because they provide super-clear pictures inside the body. Their use has transformed medicine, allowing earlier diagnoses and treatment. But the research, the latest among several papers of late to raise doubts about whether CT scans make people healthier, suggests the imaging can do more harm than good. 

We've written before about not only the potential dangers of excessive imaging -- but how it contributes to skyrocketing health care costs. Those scans are pricey and can bring in big money to doctors practices, hospitals and imaging centers.

At a time when the nation is trying to rein in health care costs, could more prudent use of CT scans help?

Continue reading "CT scans, cancer risk and health care costs" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Cancer, Health care reform
        

Just last week, the American Medical Association loudly objected to lawmakers' proposal to expand Medicare because, it insists, the federal insurance doesn't pay enough as it is.

Not all doctors agree with the AMA. In fact, in this Op-Ed published yesterday in The Sun, a group of Hopkins doctors-in-training say they would gladly accept lower salaries if it would ensure "universal, quality care for our nation."

The six authors take issue with health care's current fee-for-service model, paying physicians for each test, procedure and visit they provide.

That system "rewards specialty care while marginalizing sensible primary care, mental health and preventive medicine" the authors write. Doctors don't get reimbursed for coordinating care for chronic conditions, even though managing such disease is vital for a patient's care, they say. Salaries, which remove such incentives are the way to go, they insist.

We realize the idealism of our goals. We do not expect to donate our services or to work for fees that fail to compensate us for the extensive training we now pursue. We also realize we are asking for nothing less than an overhaul of the health care system. Nonetheless, all of us, whether bound for specialty practice, academic medicine or primary care, are committed to health care reform that places patients first.

Just a bunch of starry-eyed kids, you say? Well, they aren't the first to object to the fee-for-service model.

Continue reading "Hopkins med students: We'll trade lower pay for health reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

Maryland's former Lt. Gov. Kathleen Kennedy Townsend takes aim at American Catholic Bishops' support of restricting abortion funding in health care reform legislation.

In this fiery Op-Ed in the Politico, published just before the Senate defeated an amendment this week that would place new abortion restrictions in the health care bill, she lashes out at bishops she says have "lost their way."

Why is it that the bishops are more concerned with restricting millions of American women from making health care decisions that are best for them and their families than they are with ensuring that millions of Americans — women, men, children, immigrants, the poor, the middle class — get much-needed health insurance?

As a Catholic and neice to the late Sen. Ted Kennedy, a health care reform champion, she seems to take the U.S. Conference of Catholic Bishops actions personally. The influential bishops have emerged as a force in the health care debate, heavilly lobbying lamwakers and sending alerts to followers urging them to support the Senate amendment.

Townsend urges the bishops not to let the single issue of abortion prevent what she sees as a moral imperative of expanding health care to those who need it most.

Continue reading "Kathleen Kennedy Townsend enters the health reform fray on abortion" »

Posted by Kelly Brewington at 7:22 AM | Permalink | Comments (14)
Categories: Health care reform
        

A group that's been lobbying for health care reform is hoping to get the public in on the action tonight. The Maryland chapter of Health Care for America plans six vigils around the state around 5:30 p.m. 

The sites:

• Annapolis at 5:30 p.m.: Sen. Mikulski's District Office, 60 West St.

• Baltimore City at 5:15 p.m.: Washington Monument, 700 N. Charles St.

• Columbia at 5:30 p.m.: Corner of Little Patuxent Pkwy & Sterrett Pl. across from Columbia Mall

• Hagerstown at 5:30 p.m.: Public Square, at the intersection of Potomac & Washington streets

• Hyattsville at 5:30 p.m.: 6700 Belcrest Road

• Silver Spring at 5:30 p.m.: Woodside Park, Spring Street and Georgia Avenue

The group says it wants Congress to pass reform and make health care affordable. It also wants Congress to reform the insurance industry, avoid taxing the middle class and pass a public option -- which the groups says is supported by 70 percent of Americans. 

The group also argues that the leading cause of bankruptcy is medical debt. 

“We urge Senate Majority Leader Harry Reid, as well as Senators Cardin and Mikulski, to continue to stand with Maryland’s families by doing everything in their power to pass health care reform that provides the choice of a strong national public health insurance option. With 2,547 Americans going bankrupt from medical costs every day, we can’t allow a few senators to derail what the majority of Americans want and need,” said Matthew Weinstein, Maryland coordinator of Health Care for America Now, which is cosponsoring the vigils with MoveOn.org.

The House has passed its version of health care reform, and the Senate is currently debating its measure. If it's passed, the chambers will have to reconcile the bills.

So, if you'd like to join the lobby effort for health care reform -- or even take another position -- here's your chance.

Photo courtesy of MoveOn.org

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

For millions of laid off workers, COBRA, the federal program that allows workers to keep their health benefits, has been a lifeline.

But this week, the government ended crucial subsidies that allow many workers to afford the steep price of keeping their insurance.

That result: hundreds of thousands of workers who relied on those subsidies will be forced to pay premiums as high as three times what they are paying now.

People who began receiving the subsidies in March, when they started, lost the benefit on Monday. The subsidies last nine months.

Consumer advocacy group Families USA warns that will cause many to join the already crowded ranks of the uninsured. In Maryland, average premiums could rise from $397 a month with the subsidy, to $1,133 without the government help, according to the new study from Families USA, which outlines costs for each state and urges congress to extend the subsidies.

Some Democrats in Congress are pushing to extend the subsidies for laid off workers, according to this McClatchy story.

There's no question the subsidies have been vital to people who have been laid off. From February -- the month before the government started the subsidy -- through August, COBRA enrollment doubled, according to an analysis by Hewitt and Associates, a human relations consulting firm.

Posted by Kelly Brewington at 7:18 AM | Permalink | Comments (2)
Categories: Health care reform
        

As the Senate begins debate on its version of a health care overhaul bill, big questions remain on hot-button topics like abortion and the public option.

But another issue that will intensify debate is whether the proposal controls skyrocketing health care costs.

In a story yesterday, we examine how lawmakers are taking aim at high-cost hospitals with provisions that worry large -- and expensive-- academic medical centers such as Johns Hopkins and the University of Maryland.

Lawmakers are drawing on influential research from Dartmouth that shows huge disparities in Medicare costs in hospitals nationwide as evidence of waste in the system. Maryland ranks sixth highest in Dartmouth research of Medicare spending in the last years of a chronically ill patients' life. Hopkins and Maryland are the state's priciest hospitals.

The health care bills would examine differences in costs and could limit how much expensive hospitals get from Medicare. In addition, the bills would clamp down on overall Medicare payment rates.

Continue reading "Senate debates health care bill -- will it control costs?" »

Posted by Kelly Brewington at 12:30 PM | Permalink | Comments (4)
Categories: Health care reform
        

The volatile issue of abortion has come front and center to the health care reform battle with wrangling over health insurance coverage of the procedure.

But a new poll suggest that while most Americans don't support public funding for abortions, the issue plays only a small role among those who oppose reform, according to the poll, by the Pew Research Center.

When asked directly about whether abortion should be a benefit of a government health care reform plan, the majority -- 55 percent -- said no way. But when asked to explain in their own words their opposition to health care reform, just 3 percent of opponents said their objection to reform was because of abortion, the poll found. 

While it may not be the sole reason for discontent with the health overhaul, it was among a few. About 56 percent of opponents listed abortion as one of the major factors in their opposition, the poll found. Still, concern about costs and the expanded role of the government ranked far higher.

The poll, conducted between Nov. 12 and 15 asked a little over 1,000 people their thoughts on abortion and health care reform.

Two weeks ago, the House voted to probhibit federal subsidies for insurance that covers abortion in its version of the health care bill. The Senate's version does not have that stipulation at the moment. Expect the issue to be fought hard in the Senate. An interesting side note, this Politico story explains how taxpayers already provide subsidies for health care plans that cover abortions.

Back to the poll. While many Americans had strong feelings on the legislation proposed in Congress, lots of folks said the bills were too complicated and a good 19 percent said they didn't know what to think of them. Go figure.

Continue reading "Poll: abortion plays a small role in health reform opposition" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Health care reform
        

The Sun has launched a new feature we hope will keep us better connected with readers and help us tell stories about the economy that are most important to them. 

By joining Light Source, you'll get a monthly email asking about your experience with various economic topics. This month: health care. We'll use the answers to help shape stories that you will eventually read in The Sun's news pages and on its website. You'll be our new network of real-life experts.

We know Picture of Health readers have lots to say about health care reform. Whether you're a provider, patient or insurer, we want to hear your issues and concerns. Check it out here and let us know what you think.

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (1)
Categories: Health care reform
        

After months of partisan debate and political wrangling, the Senate Finance Committee prepares its crucial vote today on legislation to overhaul the nation's health care system and expand insurance to many of the nation's 47 million people without coverage. 

We figure this is as good a time as any to take the pulse of our Picture of Health readers on what they think of the plan.

The bill would raise the number of Americans with insurance from 83 percent to 94 percent and cost some $829 billion over a decade and Sen. Max Baucus, the committee chairman, says he's got the votes to get it approved. It would also expand Medicaid, require most Americans to have health insurance and impose a fee on most employers who don't offer insurance to their employees.

If you're interested in further details on the bill, the Kaiser Family Foundation has a great web tool that allows you to get the highlights and compare it to other plans being batted around in Congress. Check it out here.

A recent poll by Consumer Reports found that just 64 percent of Americans are satisfied with their current health care plans. Another new study by the nonpartisan think thank the Brookings Institution sheds light on how the public feels about a host of health care reform issues.

For instance, a the Brookings poll found that three in five Americans think the government has the responsibility to ensure that citizens can meet their basic need for health care and two out of three think the government is doing a bad job at meeting those needs.  Among the other key findings:

• A majority favors a public insurance option -- which would compete with the private sector -- should be available to all, while three-quarters think it should be limited to people who cannot get insurance through their employers.
• Three in four Americans said they were concerned that the cost of health insurance may soon be too great for their families to afford.
• The public is split on individual mandates -- requiring most Americans to have insurance for themselves and their children, with subsidies for low-income people to help them pay for coverage. Those who don't get insurance risk a financial penalty. 52 percent agree with the mandate, while 44 percent did not.

So, what do you think? Like a public option? Hate individual mandates? Think there's not enough pressure on insurance companies to do right by patients? Sound off!

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (8)
Categories: Health care reform
        

Everyone is making their voice heard on health care reform it seems, but there's one group that has been noticeably absent from the fray and experts say they have the most to gain from reform: minorities.

Well, this week some of the nation's most influential minority advocacy groups have stepped up to demand a voice at the table as Congress continues to battle over how to overhaul the nation's health care system. The NAACP, the National Council of La Raza and the Leadership Council on Civil Rights and others have joined forces to advocate for reform.

Blacks and Latinos are more likely than whites to go without health care because they can't afford it, are less than half as likely as whites to have a regular doctor and minorities have among the highest rates of being uninsured.

Preaching that health care is a moral imperative, the groups are taking to the airwaves with an ad campaign, for which the details can be found here: http://www.healthequityforall.org. They're pushing for a comprehensive coverage and quality for all and a plan that includes what has been at the core of the health care fight lately: a public insurance option.

Continue reading "Minorities groups speak out on health care reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

Maryland ranks 17th in the nation for health care quality, access and affordability, according to a new study by the Commonwealth Fund, which reveals stark differences in care among the states.

The state didn't make it to the top tier of 13 states such as Vermont, Hawaii and Maine who continued to improve quality measures and decrease the ranks of the uninsured. But Maryland held steady for the second year (it was ranked 16 the year before) in the second tier of states doing a decent job amid a "health care system under stress, with deteriorating health insurance coverage for adults and rising health care costs." the report states.

Maryland, for instance, is among just three states with premiums averaging under 14 percent of median income -- far more affordable than the lower ranking states, the report found. Some 83 percent of adults have insurance, just a bit lower than the 86 percent of adults who are insured in top-ranking Vermont.

Continue reading "Health care score card: Maryland ranks 17th in nation" »

Posted by Kelly Brewington at 12:19 PM | Permalink | Comments (0)
Categories: Health care reform
        

Recent data from the U.S. Census showed some stark geographic disparities in who has health insurance coverage and who doesn't.

An analysis by the Associated Press found that people who live in the Southwest are many times more likely to lack health coverage than residents in the Northeast and Midwest. The reason? Varying state laws, job industries and demographics.

The folks at NPR put together a very cool map about how congressional districts stack up. Take a look. (As a reporter who once covered demographics, I admit, I get really geeked about interactive maps!)

In addition, a piece explained how regions with the highest percentage of uninsured people also happen to be the places with the staunchest opposition to health care reform. Huh? you might ask...

Continue reading "Got health insurance? Depends where you live" »

Posted by Kelly Brewington at 7:23 AM | Permalink | Comments (0)
Categories: Health care reform
        

Our friends over at the Consuming Interest blog will hold a live chat at noon Monday on health care reform. Got questions you'd like to ask a health care expert? Columnist Eileen Ambrose will bring you two policy experts from Johns Hopkins Bloomberg School of Public Health.

Feel free to ask questions in advance by emailing Eileen: eileen.ambrose@baltsun.com.

Posted by Kelly Brewington at 4:09 PM | Permalink | Comments (0)
Categories: Health care reform
        

And you thought Death Panels was so last month. The debate over end of life costs is back at the fore this month in an interesting article in Newsweek, called "The Case for Killing Granny." 

"My mother wanted to die, but the doctors wouldn't let her," the story begins.

Beyond the provocative headline (it doesn't really advocate for offing anyone's grandma) it gets at the heart of what it calls a crucial issue facing lawmakers as they try to overhaul the health care system. "The need to spend less money on the elderly at the end of life is the elephant in the room in the health-reform debate."

It's time, the author says, to finally have a discussion about dying, something American's are terrified of.

The article makes the case that the root of uncontrolled soaring health care costs is the money spent to keep very sick, very old people alive. Doctors are encouraged to order more tests and keep treating people because of how they are paid -- by each procedure, test and doctors visit. And this fee-for-service model does not result in better quality care, the article concludes. This argument is nothing new -- articles on health care are talking about it every day. 

But what I found most interesting was the discussion near the article's end about the philosophical aspect of health care. People go to the doctor "to try to make themselves feel better, even if the doctor is not doing much physically to heal what ails them" the article states.

The story discusses a program in Massachusetts is trying to change that reliance on health care, by assigning nurses to the sickest and costliest patients, giving them basic care before deciding if a doctors visit is really necessary. The program cut costs by 5 percent.

Continue reading ""The Case for Killing Granny"" »

Posted by Kelly Brewington at 7:12 AM | Permalink | Comments (5)
Categories: Health care reform
        

Racial health disparities cost the United States $229 billion between 2003 and 2006, money that could help pay for an overhaul of the nation's health care system, according to a new report by Johns Hopkins researchers.

"The statistics are just stunning and shocking," said HHS Secretary Kathleen Sebelius, during an announcement of the findings this morning. "There is no question that reducing the health disparities can save incredible amounts of money. But more importantly it saves lives and it makes us a healthier and more prosperous nation."

Up until now, those fighting to close racial health gaps have made their pleas on moral grounds. Confronting why black men are twice as likely to have prostate cancer than white men, is simply the right thing to do, they say. But the new figures aim to break the issue down into dollars and cents at a time when everyone is concerned about soaring health care costs.

"What we are arguing in this report is if you want to get a handle on health care costs and quality and ensuring that the U.S. has a healthcare system that is worthy of this nation, you need to account for disparities," said Thomas A. LaVeist, director of the Hopkins Center for Health Disparities Solutions and the report's author. "And the economic effect of the disparities alone could likely pay for the care for those who don’t have access now."

Continue reading "Fixing racial disparities could mean billions to pay for health care reform" »

Posted by Kelly Brewington at 12:26 PM | Permalink | Comments (1)
Categories: Health care reform
        

Admit it: the health care debate is confusing. Your eyes gloss over at terms like "bending the cost curve" and "health insurance exchange." You're not sure how a public option might be different from a non-profit co-op and why you should even care.

You want to know what this plan might mean for you and you want it in simple language that makes sense.

You have plenty of company. Nearly all Americans -- 93 percent -- think the reform debate is important and yet more than two thirds -- 67 percent -- say the issue is difficult to understand, according to a new poll by the Pew Research Center for People and the Press. 

Here at Picture of Health, we don't blame you for your confusion. We, too, are sifting through the massive bills, the endless spin to help boil down the issue to important and interesting nuggets for our readers. And it's not always easy.

With that in mind, we want to help. We want to hear from you. What do you want to know about health care reform? What do you worry about most when it comes to health insurance? And if you could ask any question to a member of Congress or a health care expert what might that be?

Share here in this space, and we'll work on getting you the answers.  

AP photo

Continue reading "Confused about health care reform? Join the club" »

Posted by Kelly Brewington at 12:00 PM | Permalink | Comments (10)
Categories: Health care reform
        

Dr. Ari Silver-Isenstadt is a pediatrician. Most of his young patients have health insurance, either private or through Maryland's Children's Health Insurance Program. But, as he writes in a letter to the editor published in the Baltimore Sun today, their parents -- many times -- go uncovered. The activist Laurel doc is a major proponent for the public option as a way to ensure universal health care. Regardless of where you stand on this, listen to what he sees in his practice:

My patients' parents are less well covered. It is not unusual for a parent to ask me about his or her own health issues during a visit for the child. These parents do not have their own physicians and often they look ill; they do not have health insurance to help cover the cost of medical care. ...

Continue reading "One pediatrician's take on health care reform" »

Posted by Stephanie Desmon at 11:27 AM | Permalink | Comments (0)
Categories: Health care reform
        

The U.S. Census just released some surprising figures on the number of Americans without health insurance. The agency says the percentage of the uninsured did not grow between 2007 and 2008 -- holding steady at 15.4 percent. Meanwhile, the number of uninsured people rose slightly 45.7 million to 46.3 million.   

During a monster recession, with rising unemployment and so many employers cutting health insurance to their workers -- can those figures be right? 

Just how many Americans lack insurance has been a tough figure to pin down. In his pitch to reform the health care system and expand coverage to every American, President Obama often says there are 47 million people among the ranks of the uninsured. But other estimates from government agencies and interest groups vary widely from tens of millions of people -- in one way or another.

A closer look at the Census figures, however, sheds some light on what might be going on. For one, the number of adults without health insurance increased from 19.6 percent to 20.3 percent between 2007 and 2008, while the number of uninsured children decreased substantially, perhaps offsetting the adult numbers.

Drill down a bit more and it's clear that more Americans appear to be losing their employer-sponsored insurance while at the same time more people are getting coverage from the government -- from Medicaid, Medicare and the Children's Health Insurance Program.

Continue reading "New figures on uninsured -- but just how accurate are they?" »

Posted by Kelly Brewington at 11:35 AM | Permalink | Comments (4)
Categories: Health care reform
        

Sarah Palin is talking death panels again. This time, instead of using Facebook, she is recycling this bugaboo in the pages of The Wall Street Journal this morning.

Hoping to grab attention on the morning of the president's health care address to Congress, she criticizes Obama's desire to create an Independent Medicare Advisory Council, what she calls "an unelected, largely unaccountable group of experts charged with containing medical costs." Using Obama's words, the failed 2008 vice presidential candidate says this group "should guide decisions regarding that 'huge driver of cost ... the chronically ill and those toward the end of their lives ...'"

Given such statements, Palin writes: "[I]s it any wonder that many of the sick and elderly are concerned that the Democrats' proposals will ultimately lead to rationing of their health care by -- dare I say it -- death panels. Establishment voices dismissed that phrase, but it rang true for many Americans."

Continue reading "Deja vu: Palin and death panels" »

Posted by Stephanie Desmon at 10:39 AM | Permalink | Comments (9)
Categories: Health care reform
        

Lawmakers are back in Washington today to wrangle over health care reform -- particularly the cost of overhauling the system.

But what about the cost to individuals? Lawmakers want to expand insurance to some 47 million Americans. But what if the premiums are still too high for folks to afford them?

I take a look at the affordability question in a story today that draws on an example from Howard County. There, an innovative program offering access to doctors for as little as $50 a month -- far cheaper than any of the Congressional proposals would offer. Yet, it's still too expensive for some people.

Key to making insurance affordable would be providing subsidies large enough for low and moderate income people.  But for now, Congress hasn't decided how many people would qualify for subsidies and for how much.

Dr. Peter Beilenson, Howard County's health officer, told me that the subsidies should be vastly increased to make insurance affordable to more Americans. But just where would that money come from? For now, I guess we'll just have to stay tuned to the debate ...

photo courtesy of stock.xchng

Posted by Kelly Brewington at 7:02 AM | Permalink | Comments (5)
Categories: Health care reform
        

Checked your Facebook account lately? Are you seeing what we are? Status updates that go something like this:

No one should die because they cannot afford health care, and no one should go broke because they get sick. If you agree, please post this as your status for the rest of the day

Or this:

No one should die, go blind, or be crippled because they can't afford health care. No one should go broke because they get sick. No one should be unable to change jobs because of a "pre-existing condition." If you agree, please post this as your status for the rest of the day.

The beginning of a health care reform movement? Or just idle chit chat on a social networking site where folks are constantly trying to impress their "friends?" And will an anti-reform response be next?

AP photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

Whether spending now to prevent chronic illnesses actually reins in costs is a huge issue  lawmakers will confront when they return to Washington next week to battle out health care reform.

Many lawmakers and the Obama administration assert there will be huge savings down the road from preventing chronic diseases now -- enough to pay for a health care overhaul. But a new study from the journal Health Affairs, pokes holes in those claims. Researchers found that while costs will likely decrease over time, prevention efforts will not result in enough savings to pay for reforming the entire health care system. 

Still, the authors say, if the government took a longer view on costs, it would see greater savings. The Congressional Budget Office projects the cost of prevention efforts over 10 years, and finds that most preventive services, result in greater spending, not savings. But the study's authors think the government would find a rosier picture if it projected out 25 years. The bottom line:

 "There's no free lunch here. Prevention will not pay for everything. But it's not as expensive as it looks at first blush," said Michael J. O'Grady, a senior fellow at the National Opinion Research Center at the University of Chicago, told the Washington Post.

Continue reading "Does preventing chronic illness now pay off later? " »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (1)
Categories: Health care reform
        

Caught this testy exchange this morning on NPR as I drove into the parking lot: Morning Edition host Steve Inskeep taking on RNC Chairman Michael S. Steele, Maryland's former lt. governor.

The topic: Health care reform, what else? Inskeep took Steele to task for an op-ed piece he wrote for Monday's Washington Post. In it, Steele wrote a clever line I'm sure he has used more than once: "President Obama's plan for a government-run health-care system is the wrong prescription." Later, he lays out his call for a "Seniors' Health Care Bill of Rights." The First Amendment: Don't cut Medicare, a program he acknowledges is going to run out of money.

"Within a couple of paragraphs of writing we need to protect Medicare, you write that you oppose President Obama's plan for a 'government-run health-care system,'" Inskeep said. "Now you're a veteran public policy official. You're aware that Medicare is a government-run health care program?"

Continue reading "NPR vs. Michael Steele on government-run health care" »

Posted by Stephanie Desmon at 11:15 AM | Permalink | Comments (21)
Categories: Health care reform
        

As friends, colleagues and even political adversaries offer praise and remembrances for Sen. Edward Kennedy, who died last night after a battle with brain cancer, everyone underscores his huge influence on efforts to overhaul the nation's health care system.

He called health reform the "cause of my life" during last year's Democratic National Convention, said it was a "defining issue for our society" years earlier, and throughout his recent illness continued to champion universal coverage while pushing Congress to act now on legislation.

"He pursued that cause vigorously, even as his health declined; when members of Obama’s administration questioned the president’s decision to spend so much political capital on the seemingly intractable issue, Obama reportedly replied, “I promised Teddy.’’ noted The Boston Globe adding that Kennedy's long committment to health care issues began in 1969.

Yet, he died with "one of his lifelong goals, universal health care, tantalizingly within reach yet struggling on Capitol Hill."

Beyond reform, Kennedy was instrumental in other legislative issues concerning health including helping create state health coverage for poor children known as S-CHIP, building federal support for community health centers and pushing successfully for increases in cancer reasearch funding.

The Wall Street Journal notes that his death has already become a rallying cry for passing reform legislation this year while others ponder, who will fill the shoes of the man called the lion of the Senate?

photo: AFP/Getty imags

Posted by Kelly Brewington at 1:20 PM | Permalink | Comments (2)
Categories: Health care reform
        

And you thought the uproar over "death panels" had reached a fever pitch. Well, here's another topic making the heated rounds in the health care reform brawls: Should illegal immigrants be eligible for coverage?

First off, none of the plans currently in Congress include illegal immigrants. President Obama and Nancy Pelosi have made a point of underscoring this lately. In fact, up until the town halls got ugly in recent weeks, no one in Congress was even talking about health insurance for illegal immigrants. That hasn't stopped angry opponents from asserting all sorts of false claims -- free insurance to non-citizens, among them. (PolitiFact debunks a that claim, for the record.)

It also hasn't stopped immigrant advocates from asking -- wait a second, what about us?

There's a moral obligation to provide access to health coverage to all Americans, regardless of their immigration status, they say. Any plan that excludes illegal immigrants will fall short, says the advocacy group the National Council of La Raza, considering that illegal immigrants account for 15 percent -- nearly 7 million -- of the nation's 47 million uninsured. But proponents of strict immigration enforcement counter that providing insurance would only encourage more immigrants to flock here illegally.

Continue reading "Illegal immigrants and health care reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (40)
Categories: Health care reform
        

Laid-off workers have been flocking in recent months to COBRA, the federal program that has long allowed them to keep their employers' health insurance for 18 months -- but for a hefty price.

Lots of people have become eligible for the program -- with unemployment at a 25-year high -- but few are able to afford it when they lose their income. COBRA allows involuntarily terminated to pay 100 percent of the premium plus 2 percent for administrative costs. The cost: roughly $8,800 a year for the average worker.

The doubling of COBRA enrollment has been since February, when the government began paying a subsidy to make the coverage actually affordable to some unemployed people, according to an analysis by Hewitt Associates, a human resources consulting firm.

Continue reading "COBRA enrollment doubles with subsidy, study says" »

Posted by Stephanie Desmon at 10:47 AM | Permalink | Comments (0)
Categories: General Health, Health care reform
        

Apparently cowed by protestors and talking heads who called plans to pay doctors to assist with end-of-life decisions "death panels," a Senate committee has dropped the provision from its health care reform bill.

The idea was to let Medicare pay for these voluntary counseling sessions, where items such as living wills and hospice care would be discussed. What rankled many seemed to be that these sessions were billed as cost-saving measures. The last year of life is the most expensive and one recent study concluded that much of end-of-life spending isn't sought by patients and goes against their families' wishes, according to yesterday's Wall Street Journal.

But many saw a more sinister motive. They equated these end-of-life sessions with rationing care for the elderly and even euthanasia, calling them death panels which would play God and decide who would live and who would die. And the concerns didn't only come from sign-waving protestors and an angry Sarah Palin, the failed 2008 vice presidential candidate. Sen. Charles Grassley, the top Republican on the Senate Finance Committee, said yesterday that the provision was dropped because it wasn't just about providing information at the end of life, but was "likely to lead to the rationing of care for everyone."

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Posted by Stephanie Desmon at 7:17 AM | Permalink | Comments (10)
Categories: Health care reform
        

The White House launched full court press against what it says is misinformation being spread about health care reform by protesters at raucous town halls nationwide.

On Monday, the administration released a new website aimed at countering the attacks and at a town hall Tuesday, President Obama said flat out: his health care plan won't "pull the plug on grandma."

He was referring to euthanasia claims made by fierce opponents to reform proposals, including none other than Sarah Palin, who said on her Facebook page that the "downright evil" plan will lead to health care rationing:

"The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care."

Now, let's get this straight. Palin was referring to a provision that would allow Medicare to reimburse doctors for consulting seniors about living wills, advanced directives and end-of-life care. Sound like a death panel to you? The Associated Press says there's nothing in the bill about "death panels". Pulitzer-prize winning PolitiFact.com also debunks the claim. And if you're interested, here's the actual bill with the information -- see pg. 425,.

Continue reading ""Death Panels" and the war of words over health care reform" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (2)
Categories: Health care reform
        

My Sunday story focused on a key question in health care reform -- will there be enough doctors to go around? With plans to extend insurance to some 47 million people, the current primary care doctor shortage will only get worse, many say. One solution could be to increase the role of nurse practitioners. 

The piece generated positive feedback and lots of interesting responses from readers across the spectrum about primary care, nursing and the reform debate. I also heard from a group of providers who felt overlooked: physician assistants.

I hope folks don't see this as an intentional slight, as the story was a narrowly-focused piece looking at one slice of the health care debate. But it is true that using more physician assistants is among the solutions being tossed around to help fill the primary care gaps. And some observers think they could play an important role.

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Posted by Kelly Brewington at 11:11 AM | Permalink | Comments (9)
Categories: Health care reform, Physician shortage